应用ROC曲线评价5'-NT和甲胎蛋白联合检测在早期原发性肝细胞癌诊断中的价值

目的:应用ROC曲线评价血清5'-核苷酸酶（5'-NT）和甲胎蛋白（AFP）联合检测在原发性肝细胞癌（hepatocellular carcinoma,HCC）诊断中的应用，以寻找一组诊断HCC更敏感的指标，为早期诊断及治疗提供依据。方法:分别采用过氧化物酶法及电化学发光免疫分析法测定132例肝细胞癌患者（肝细胞癌组）、85例肝硬化患者（肝硬化组）、138例肝炎患者（肝炎组）和100例健康体检者（对照组）的血清5'-NT和AFP的浓度，并使用统计学软件对结果进行处理及分析。结果:血清5'-NT和AFP的水平在HCC组、肝硬化组、肝炎组和对照组间存在显著性差别，差异具有统计学意义（P＜0.05）；二者联合检测HCC的敏感度为93.94%，较单项检测高（P＜0.05），特异度为84.10%；二者联合诊断HCC的曲线下面积为0.948，较单项高，差异亦具有统计学意义（P＜0.05）。结论:血清5'-NT和AFP联合检测可提高HCC诊断的敏感度和准确度，对HCC的早期诊断具有十分重要的临床价值。

Early diagnostic combined detection of serum AFP and 5'-NT in hepatocellular carcinoma by ROC

Objective:To investigate the diagnostic value of combined detection of serum 5'-NT and AFP in hepatocellular carcinoma(HCC) by ROC.Methods:The level of serum 5'-NT and AFP in hepatocellular carcinoma group(132 cases),hepatic cirrhosis group(85 cases)、hepatitis group(138 cases) and control group(100 cases) were detected by peroxidase method and electrochemiluminescence immunoassay(ECLI).Results:The levels of serum 5'-NT and AFP were significantly different between HCC group,hepatic cirrhosis group、hepatitis group and control group,difference was statistically significant(P＜0.05).The sensitivity of two indicators for diagnosing HCC was 93.94%,which was higher than single detection(P＜0.05),the specificity was 84.10%,the area under ROC curves of combined detection of two indicators was 0.948,which was also higher than single detection(P＜0.05).Conclusion:The combined detection of serum 5'-NT and AFP can greatly increase the sensitivity and accuracy for diagnosing HCC,which has an important clinical value for early diagnosis.