CAJ | 학술논문

目的探讨血清胱抑素C(Cys-C)、5'-核苷酸酶(5'-NT)和甲胎蛋白(AFP)单独及联合检测在肝细胞癌(HCC)诊断中的应用,为早期诊断及预后评估提供依据.方法分别采用胶乳增强免疫透射比浊法、过氧化物酶法和电化学发光免疫分析法测定148例HCC患者(HCC组)、135例肝硬化患者(肝硬化组)、155例肝炎患者(肝炎组)和100名健康体检者(对照组)的血清Cys-C、5'-NT和AFP含量,比较其差异,计算敏感度、特异度及约登指数,并应用受试者工作特征(ROC)曲线进行分析.结果血清Cys-C、5’-NT和AFP的水平在HCC组、肝硬化组、肝炎组和对照组之间差异均具有统计学意义(F值分别为12.35、42.25、58.12,P值均为0.000).三者联合检测HCC的敏感度为100％,较单项及两两联合检测的敏感度均高,差异有统计学意义(P＜0.05),而特异度为78.97％;二者联合检测HCC的ROC曲线下面积为0.977,较单项及两两联合检测结果均高,差异亦具有统计学意义(P＜0.05).结论血清Cys-C、5’-NT和AFP联合检测可提高HCC诊断的敏感性和准确性,对HCC的早期诊断具有重要价值,值得在临床上推广应用.
목적 탐토혈청광억소C(Cys-C)、5'-핵감산매(5'-NT)화갑태단백(AFP)단독급연합검측재간세포암(HCC)진단중적응용,위조기진단급예후평고제공의거.방법 분별채용효유증강면역투사비탁법、과양화물매법화전화학발광면역분석법측정148례HCC환자(HCC조)、135례간경화환자(간경화조)、155례간염환자(간염조)화100명건강체검자(대조조)적혈청Cys-C、5'-NT화AFP함량,비교기차이,계산민감도、특이도급약등지수,병응용수시자공작특정(ROC)곡선진행분석.결과 혈청Cys-C、5’-NT화AFP적수평재HCC조、간경화조、간염조화대조조지간차이균구유통계학의의(F치분별위12.35、42.25、58.12,P치균위0.000).삼자연합검측HCC적민감도위100％,교단항급량량연합검측적민감도균고,차이유통계학의의(P＜0.05),이특이도위78.97％;이자연합검측HCC적ROC곡선하면적위0.977,교단항급량량연합검측결과균고,차이역구유통계학의의(P＜0.05).결론 혈청Cys-C、5’-NT화AFP연합검측가제고HCC진단적민감성화준학성,대HCC적조기진단구유중요개치,치득재림상상추엄응용.
Objective To explore the clinical application of single or combined detection of serum Cys-C,5'-NT and AFP in hepatocellular carcinoma (HCC) in order to provide the platform for early diagnosis and prognosis evaluation.Methods The serum levels of Cys-C,5'-NT and AFP from 148 cases of HCC patients (HCC group),135 cases of liver cirrhosis patients (LC group) and 155 cases of hepatitis (hepatitis group) and 100 healthy people (control group) were measured by latex-enhanced immunoturbidimetric assay (LEITD),peroxidase method and electrochemiluminescence immunoassay (ECLI),respectively.Then their differences had been compared.The sensitivity,specificity and Youden's index were calculated and the results were analyzed by receiver operating characteristic (ROC) curve.Results The levels of serum Cys-C,5'-NT and AFP were significantly different in 4 groups.The differences were statistically significant (F =12.35,42.25,58.12,P =0.000).The sensitivity of three indicators for diagnosing HCC was 100 ％,which was higher than that of single or two combined detection (P ＜ 0.05),and the specificity was 78.97 ％.The area under ROC curves of combined detection of three indicators was 0.977,which was also higher than single or two combined detection (P ＜ 0.05).Conclusions The combined detection of serum Cys-C,5'-NT and AFP can greatly increase the sensitivity and accuracy for diagnosing HCC,which has an important clinical value for early diagnosis.Therefore it is worth popularizing and applying on clinic.