CAJ | 학술논문

目的：检测肝病患者血清中甲胎蛋白异质体（ AFP-L3）和高尔基体蛋白73（ GP73）浓度，分析肝病患者病灶CT平扫加增强扫描后经处理技术得到二维及三维重建图像，探讨联合运用AFP-L3、GP73浓度检测与CT扫描两种技术在肝细胞癌（ hepatocellular carcinoma，HCC）诊断中的价值。方法：采用酶联免疫吸附法检测肝病患者血清AFP-L3、GP73浓度，运用受试者工作特征曲线（ recover operation characteristic，ROC）确定AFP-L3、GP73浓度诊断HCC的cut-off值。分析141例肝病患者总共164个病灶的CT扫描后经处理技术得到二维及三维重建图像而诊断HCC，探讨采用AFP-L3、GP73浓度测定与CT增强扫描及这两种方法联合应用在HCC的检出与定性诊断方面的价值。结果：HCC组AFP-L3浓度（113.58±63.62）ng/ml明显高于良性肝病组[（23.19±34.54）ng/ml，p<0.001]，绘制AFP-L3浓度诊断 HCC 的 ROC 曲线，AFP-L3浓度38.47ng/ml为诊断HCC的cut-off值，诊断敏感性为81.08%，特异性为88.06%，诊断正确率为87.23%；HCC组GP73浓度（126.55±49.56）ng/ml明显高于良性肝病组[（56.97±26.48）ng/ml，p<0.001]，绘制GP73浓度诊断HCC的ROC曲线，GP73浓度69.44ng/ml为诊断HCC的cut-off值，诊断敏感性为75.68%，特异性为91.04%，诊断正确率为88.65%。CT扫描诊断HCC的灵敏度为82.43%，特异度为91.04%，诊断正确率为90.07%。联合AFP-L3、GP73浓度检测与 CT 扫描诊断 HCC 的灵敏度为85.14%，特异度为92.53%，诊断正确率为92.19%。结论：联合运用血清AFP-L3、GP73浓度检测及CT扫描两种技术对HCC诊断灵敏度、特异度、诊断正确率较运用单一技术均有所提高，联合运用两种技术对HCC的准确早期诊断具有积极的意义。
목적：검측간병환자혈청중갑태단백이질체（ AFP-L3）화고이기체단백73（ GP73）농도，분석간병환자병조CT평소가증강소묘후경처리기술득도이유급삼유중건도상，탐토연합운용AFP-L3、GP73농도검측여CT소묘량충기술재간세포암（ hepatocellular carcinoma，HCC）진단중적개치。방법：채용매련면역흡부법검측간병환자혈청AFP-L3、GP73농도，운용수시자공작특정곡선（ recover operation characteristic，ROC）학정AFP-L3、GP73농도진단HCC적cut-off치。분석141례간병환자총공164개병조적CT소묘후경처리기술득도이유급삼유중건도상이진단HCC，탐토채용AFP-L3、GP73농도측정여CT증강소묘급저량충방법연합응용재HCC적검출여정성진단방면적개치。결과：HCC조AFP-L3농도（113.58±63.62）ng/ml명현고우량성간병조[（23.19±34.54）ng/ml，p<0.001]，회제AFP-L3농도진단 HCC 적 ROC 곡선，AFP-L3농도38.47ng/ml위진단HCC적cut-off치，진단민감성위81.08%，특이성위88.06%，진단정학솔위87.23%；HCC조GP73농도（126.55±49.56）ng/ml명현고우량성간병조[（56.97±26.48）ng/ml，p<0.001]，회제GP73농도진단HCC적ROC곡선，GP73농도69.44ng/ml위진단HCC적cut-off치，진단민감성위75.68%，특이성위91.04%，진단정학솔위88.65%。CT소묘진단HCC적령민도위82.43%，특이도위91.04%，진단정학솔위90.07%。연합AFP-L3、GP73농도검측여 CT 소묘진단 HCC 적령민도위85.14%，특이도위92.53%，진단정학솔위92.19%。결론：연합운용혈청AFP-L3、GP73농도검측급CT소묘량충기술대HCC진단령민도、특이도、진단정학솔교운용단일기술균유소제고，연합운용량충기술대HCC적준학조기진단구유적겁적의의。
Objective:To explore the value of detecting the serum AFP-L3,GP73 level,CT scanning and parallel use the two kinds of technologies in the early diagnosis of hepatocellular carcinoma( HCC). Methods:To use ELISA method to test the serum AFP-L3 and GP73 levels,ROC curve to determine the cut-off level to diagnose HCC. To analyze 164 lesions of 141 patients with liver diseases lesions by CT scan and three dimensional reconstruction ima-ges. To explore the value of parallel use AFP-L3,GP73 and CT scan in HCC diagnosis. Results:The average level of AFP-L3 in the patients with HCC was(113. 58 ± 63. 62)ng/ml significantly higher than those the patients with be-nign liver diseases[(23. 19 ± 34. 54)ng/ml,p<0. 001]. Taking AFP-L3 level≥38. 47ng/ml as diagnostic crite-ria,the sensitivity of AFP-L3 level in HCC diagnosis was 81. 08% and the specificity was 88. 06%,the accuracy was 87. 23%. The average level of GP73 in the patients with HCC was(126. 55 ± 49. 56 )ng/ml significantly higher than those the patients with benign liver diseases[( 56. 97 ± 26. 48)ng/ml,p<0. 001]. Taking GP73 level≥69. 44ng/ml as diagnostic criteria,the sensitivity of GP73 level in HCC diagnosis was 75. 68% and the specificity was 91. 04%,the accuracy was 88. 65%. Use CT scan in HCC diagnosis,the sensitivity was 82. 43%,the specificity was 91. 04%,the accuracy was 90. 07%. Parallel serum AFP-L3,GP73 level and CT scan images in HCC diagnosis,the sensitivity was 85. 14%,specificity was 92. 53%,accuracy was 92. 19%. Conclusion:The diagnostic sensitivity,spe-cificity and accuracy were higher of parallel use AFP-L3/AFP and CT scan in the diagnosis of HCC compared with application of one single way,parallel use two kinds of methods for accurate early diagnosis of HCC is useful.