比较用凝集素微量离心柱法和酶联免疫吸附法检测甲胎蛋白异质体对原发性肝癌的诊断价值
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摘要
目的比较用凝集素微量离心柱法(ACSC)和酶联免疫吸附法(ELISA)检测甲胎蛋白异质体对原发性肝癌的诊断价值。方法选取2013年7月至2015年12月于本院就诊的原发性肝癌(HCC)患者85例,慢性肝炎(CH)与肝硬化(LC)患者38例;用ELISA法检测甲胎蛋白异质体(AFP-L3)浓度,用ACSC法检测AFP(甲胎蛋白)-L3/AFP%,比较2种检测办法对良恶性肝病的鉴别诊断价值。结果 ACSC法在HCC中AFP-L3/AFP%≥10%阳性率为84.70%(72例/85例),ELISA法在HCC中AFP-L3>37.89 ng·m L~(-1)的阳性率为90.59%(77例/85例)。2种方法检测CH与LC的阳性率分别为13.16%(5例/38例)、10.53%(4例/38例),两者比较差异有统计学意义(P<0.05)。在2种方法对良恶性肝病鉴别诊断性能评价的ROC曲线中,AUC值分别为0.89,0.82(均P<0.01),95%可信区间分别为0.81~0.98,0.74~0.90。2种方法诊断HCC的敏感性分别为84.71%(72例/85例),88.24%(75例/85例);特异性分别为86.84%(33例/38例),89.47%(34例/38例);准确性分别为85.36%(105例/123例),88.62%(109例/123例),这三者比较差异无统计学意义(均P>0.05)。结论 2种方法诊断HCC的敏感性、特异性、准确性类似,但ELISA法具有操作简单、价格低廉等优点,更适合在临床上推广应用。
Objective To compare the value of lens culinaris agglutinin coupled spin column( ACSC) method and enzyme linked immunosorbent assay( ELISA) for the measurement of α-fetoprotein( AFP-L3) in the diagnosis of hepatocellular carcinoma( HCC). Methods A total of 85 cases of HCC patients in our hospital,38 cases of patients with chronic hepatitis( CH) and liver cirrhosis( LC) in our hospital were selected from July 2013 to December 2015. The α fetal protein heterogeneity( AFP-L3) concentrations and AFP-L3/AFP% of the patients were detected by ACSC and ELISA separately. The differentiate diagnosis value of both detection methods were compared. Results The positive rate of AFP-L3/AFP% ≥ 10% in HCC used ACSC was 84. 70%( 72 cases/85 cases). The positive rate of AFP-L3/AFP% > 37. 89 ng · m L~(-1) in HCC used ELISA was 90. 59%( 77 cases/85 cases). The positive rates of CH and LC in ACSC and ELISA were 13. 16%( 5 cases/38 cases),10. 53%( 4 cases/38 cases) respectively,and the differences of positive rate in two mothods were statistical significance( P < 0. 05). The values of AUC of ROC curve in ACSC and ELISA were 0. 89,0. 82( all P < 0. 01); 95% confidence interval was 0. 81-0. 98,0. 74-0. 90. The sensitivity of the two methods was 84. 71%( 72 cases/85 cases),88. 24%( 75 cases/85 cases); the specificity was 86. 84%( 33 cases/38 cases),89. 47%( 34 cases/38 cases); the accuracy was 85. 36%( 105 cases/123 cases),88. 62%( 109 cases/123 cases). The sensitivity,specificity and accuracy of the two methods in the diagnosis of HCC were not statistical significance( all P > 0. 05). Conclusion ACSC and ELISA in the diagnosis of HCC have an similar in sensitivity,specificity,accuracy; but ELISA method has the advantages of simple operation,low cost,more suitable for clinical application.
Objective To compare the value of lens culinaris agglutinin coupled spin column( ACSC) method and enzyme linked immunosorbent assay( ELISA) for the measurement of α-fetoprotein( AFP-L3) in the diagnosis of hepatocellular carcinoma( HCC). Methods A total of 85 cases of HCC patients in our hospital,38 cases of patients with chronic hepatitis( CH) and liver cirrhosis( LC) in our hospital were selected from July 2013 to December 2015. The α fetal protein heterogeneity( AFP-L3) concentrations and AFP-L3/AFP% of the patients were detected by ACSC and ELISA separately. The differentiate diagnosis value of both detection methods were compared. Results The positive rate of AFP-L3/AFP% ≥ 10% in HCC used ACSC was 84. 70%( 72 cases/85 cases). The positive rate of AFP-L3/AFP% > 37. 89 ng · m L~(-1) in HCC used ELISA was 90. 59%( 77 cases/85 cases). The positive rates of CH and LC in ACSC and ELISA were 13. 16%( 5 cases/38 cases),10. 53%( 4 cases/38 cases) respectively,and the differences of positive rate in two mothods were statistical significance( P < 0. 05). The values of AUC of ROC curve in ACSC and ELISA were 0. 89,0. 82( all P < 0. 01); 95% confidence interval was 0. 81-0. 98,0. 74-0. 90. The sensitivity of the two methods was 84. 71%( 72 cases/85 cases),88. 24%( 75 cases/85 cases); the specificity was 86. 84%( 33 cases/38 cases),89. 47%( 34 cases/38 cases); the accuracy was 85. 36%( 105 cases/123 cases),88. 62%( 109 cases/123 cases). The sensitivity,specificity and accuracy of the two methods in the diagnosis of HCC were not statistical significance( all P > 0. 05). Conclusion ACSC and ELISA in the diagnosis of HCC have an similar in sensitivity,specificity,accuracy; but ELISA method has the advantages of simple operation,low cost,more suitable for clinical application.
引文
[1]MA L,JI L,YU Y,et al.Novel molecular targets for diagnosis and treatment of hepatocellular carcinoma[J].Discov Med,2015,19(102):7-14.
[2]Ch EN T,HE Y,LIU X,et al.Nucleoside analogues improve the short-term and long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure[J].Clin Exp Med,2012,12(3):159-164.
[3]RICH N,SINGAL A.Hepatocellular carcinoma tumour markers:current role and expectations[J].Best Pract Res Clin Gastroenterol,2014,28(5):843-853.
[4]马端叶,于丽梅,封建凯,等.甲胎蛋白异质体检测在肝癌诊断中的应用[J].当代医学,2011,17(36):113-114.
[5]黄彩云,韩素桂,张景华,等.ELISA法检测甲胎蛋白异质体用于肝癌诊断的探讨[J].标记免疫分析与临床,2012,19(3):147-149.
[6]许成新,褚邦勇,徐玖飞,等.甲胎蛋白、甲胎蛋白异质体、铁蛋白和肿瘤相关因子联合检测在原发性肝癌诊断中的价值[J].中国卫生检验杂志,2012,31(2):308-311.
[7]施昌村,韩必亮,黄崇权.CT扫描联合血清甲胎蛋白检测在原发性肝癌诊断中的意义[J].中国中西医结合消化杂志,2014,22(12):744-745.
[2]Ch EN T,HE Y,LIU X,et al.Nucleoside analogues improve the short-term and long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure[J].Clin Exp Med,2012,12(3):159-164.
[3]RICH N,SINGAL A.Hepatocellular carcinoma tumour markers:current role and expectations[J].Best Pract Res Clin Gastroenterol,2014,28(5):843-853.
[4]马端叶,于丽梅,封建凯,等.甲胎蛋白异质体检测在肝癌诊断中的应用[J].当代医学,2011,17(36):113-114.
[5]黄彩云,韩素桂,张景华,等.ELISA法检测甲胎蛋白异质体用于肝癌诊断的探讨[J].标记免疫分析与临床,2012,19(3):147-149.
[6]许成新,褚邦勇,徐玖飞,等.甲胎蛋白、甲胎蛋白异质体、铁蛋白和肿瘤相关因子联合检测在原发性肝癌诊断中的价值[J].中国卫生检验杂志,2012,31(2):308-311.
[7]施昌村,韩必亮,黄崇权.CT扫描联合血清甲胎蛋白检测在原发性肝癌诊断中的意义[J].中国中西医结合消化杂志,2014,22(12):744-745.