铜川地区肝癌与癌前病变患者γ-GT、AKP、SFe差异表达分析
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摘要
目的探讨铜川地区肝癌与癌前病变患者γ-GT、AKP、SFe差异表达分析。方法收集2015年3月至2018年3月期间在铜川矿务局中心医院诊治的86例肝癌患者及癌前病变患者,以40例肝癌患者为肝癌组,46例癌前病变患者为癌前病变组,另外选取30例健康体检志愿者为对照组,分别检测三组对象血清AFP、CEA、γ-GT、AKP、SFe表达水平及阳性率。结果肝癌组及癌前病变组AFP、CEA、AKP、γ-GT及SFe水平均明显高于对照组(P<0.05),且肝癌组显著高于癌前病变组(P<0.05)。γ-GT在肝癌组的阳性率明显高于AFP和CEA(χ~2=5.952,18.620;P<0.05),同时AKP在肝癌组的阳性率显著高于CEA(χ~2=7.200,P<0.05);肝癌组AFP、CEA、AKP、γ-GT阳性率均明显高于癌前病变组和对照组(P<0.05)。AFP、CEA、AKP、γ-GT联合检测对肝癌的敏感性、特异性、阳性预测值及阴性预测值均明显高于AFP+CEA联合检测(P<0.05)。结论 AFP、CEA、AKP、γ-GT及SFe各指标在肝癌患者、癌前病变患者及正常健康者表达存在差异,且其联合检测可提高肝癌诊断的敏感性及特异性,可作为肝癌诊断的重要参考指标。
Objective To investigate the differential expressions of γ-GT,AKP,SFe in patients with hepatocellular carcinoma and precancerous lesions in Tongchuan. Methods From March 2015 to March 2018,eighty-six patients with liver cancer and precancerous lesions were diagnosed and treated in Central Hospital of Tongchuan Mining Bureau. Forty-six of these patients with precancerous lesions were assigned to the precancerous lesion group,and 40 patients with liver cancer were selected as the liver cancer group. In addition,thirty healthy volunteers served as the control group. Results The levels of AFP、CEA、γ-GT、AKP and SFe in the liver cancer group and in the precancerous lesion group were significantly higher than those of the control group( P<0. 05),and they were significantly higher in the liver cancer group than those of the precancerous lesion group( P<0. 05). The positive rate of γ-GT in the liver cancer group was significantly higher than that of AFP and CEA( χ~2= 5. 952,P<0. 05). At the same time,the positive rate of AKP in the liver cancer group was significantly higher than that of CEA( χ~2=7. 200,P<0. 05). In addition,the positive rates of AFP、CEA、γ-GT and AKP in the liver cancer group were significantly higher than those in the precancerous lesion group and control group( P<0. 05). The sensitivity,specificity,positive predictive value and negative predictive value of combined detection of AFP+ CEA+AKP+γ-GT were significantly higher than those of AFP+CEA( P<0. 05). Conclusion The expressions of AFP,CEA,AKP,γ-GT and SFe in patients with liver cancer,precancerous lesions and normal controls are different. The combined detection can improve the sensitivity and specificity of the diagnosis of liver cancer and can be used as an important reference index for the diagnosis of liver cancer.
Objective To investigate the differential expressions of γ-GT,AKP,SFe in patients with hepatocellular carcinoma and precancerous lesions in Tongchuan. Methods From March 2015 to March 2018,eighty-six patients with liver cancer and precancerous lesions were diagnosed and treated in Central Hospital of Tongchuan Mining Bureau. Forty-six of these patients with precancerous lesions were assigned to the precancerous lesion group,and 40 patients with liver cancer were selected as the liver cancer group. In addition,thirty healthy volunteers served as the control group. Results The levels of AFP、CEA、γ-GT、AKP and SFe in the liver cancer group and in the precancerous lesion group were significantly higher than those of the control group( P<0. 05),and they were significantly higher in the liver cancer group than those of the precancerous lesion group( P<0. 05). The positive rate of γ-GT in the liver cancer group was significantly higher than that of AFP and CEA( χ~2= 5. 952,P<0. 05). At the same time,the positive rate of AKP in the liver cancer group was significantly higher than that of CEA( χ~2=7. 200,P<0. 05). In addition,the positive rates of AFP、CEA、γ-GT and AKP in the liver cancer group were significantly higher than those in the precancerous lesion group and control group( P<0. 05). The sensitivity,specificity,positive predictive value and negative predictive value of combined detection of AFP+ CEA+AKP+γ-GT were significantly higher than those of AFP+CEA( P<0. 05). Conclusion The expressions of AFP,CEA,AKP,γ-GT and SFe in patients with liver cancer,precancerous lesions and normal controls are different. The combined detection can improve the sensitivity and specificity of the diagnosis of liver cancer and can be used as an important reference index for the diagnosis of liver cancer.
引文
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[12]李坤,陈朗.血清谷氨酰氨基转移酶、碱性磷酸酶及甲胎蛋白联合检测对肝癌的诊断价值分析[J].世界临床医学,2017,11(12):35.
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[15]李婷婷,裘淼,王莺,等.γ-谷氨酰转移酶/白蛋白的比值在预测肝细胞肝癌中的意义[J].浙江临床医学,2017,19(6):1134.
[2]王黎君,殷鹏,刘韫宁,等.1990年与2013年中国人群肝癌疾病负担研究[J].中华流行病学杂志,2016,37(6):758.
[3]张健,邵初晓.原发性肝癌早期诊断的研究进展[J].中华肝胆外科杂志,2014,20(9):689.
[4]杨璐宇,钦伦秀.2017年美国临床肿瘤学会年会肝癌诊断与治疗研究热点和最新进展解析[J].中华消化外科杂志,2017,16(7):674.
[5]胡友明,张娟安,刘军,等.AFP、AFU、GPC3及GP73联合检测对原发性肝癌的诊断意义[J].实用癌症杂志,2017,32(3):375.
[6]QIN Q F,WENG J,XU G X,etal.Combination of serum tumor markers dickkopf-1,DCP and AFP for the diagnosis of primary hepatocellular carcinoma[J].Asian Pacific Journal of Tropical Medicine,2017,10(4):409.
[7]郑海伦,赵睿,李大鹏,等.肿瘤标志物DCP和AFP在原发性肝癌中的诊断价值[J].中华全科医学,2016,14(1):29.
[8]刘永炜,吴向民.血清AFP、CA199和CEA水平在肝癌诊断和预后中的作用[J].检验医学,2017,32(5):406.
[9]袁星星,姜菲菲,贾泳梅,等.血清铁蛋白和甲胎蛋白及甲胎蛋白异质体-L3单项与联合检测对原发性肝癌辅助诊断的临床应用价值[J].中华检验医学杂志,2016,39(8):604.
[10]程丹,邵志林,吴亮,等.慢性肝病及肝癌患者血清铁蛋白的检测意义[J].肝脏,2017,22(4):339.
[11]牛广林,程昌盛,潘卫珍,等.血清铁蛋白水平诊断原发性肝癌的价值[J].广西医学,2018(2):209.
[12]李坤,陈朗.血清谷氨酰氨基转移酶、碱性磷酸酶及甲胎蛋白联合检测对肝癌的诊断价值分析[J].世界临床医学,2017,11(12):35.
[13]胡世坤.生化检验项目用于肝硬化疾病诊断中的临床价值[J].医药论坛杂志,2017(4):168.
[14]宋森涛,朱峰,孙燕,等.联合检测血清AFP、AFU和ALP对原发性肝癌诊断的价值[J].国际消化病杂志,2017,37(3):177.
[15]李婷婷,裘淼,王莺,等.γ-谷氨酰转移酶/白蛋白的比值在预测肝细胞肝癌中的意义[J].浙江临床医学,2017,19(6):1134.