血清甲胎蛋白、血管内皮生长因子、p53抗体诊断原发性肝细胞癌的临床价值

目的探讨血清甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、p53抗体诊断原发性肝细胞癌(HCC)的临床价值。方法选取2011年9月至2014年6月我院收治的79例HCC患者作为病例组,选取同期我院收治的65例肝硬化(HC)患者作为对照1组,另外选取同期我院体检科确诊的72例健康对照者作为对照2组,所有患者均接受AFP、VEGF、p53抗体测定,其中AFP测定采用电化学发光法,VEGF、p53抗体测定采用酶联免疫吸附试验(ELISA)。结果 1病例组血清AFP、VEGF、p53抗体显著高于对照1组(P0.01),对照1组血清AFP、VEGF、p53抗体显著高于对照2组(P0.01)。2绘制受试者工作特征(ROC)曲线,得到AFP、VEGF、p53抗体诊断HCC的ROC曲线下面积(AUC)分别为0.843(95%CI,0.738~0.905)、0.827(95%CI,0.731~0.899)、0.634(95%CI,0.515~0.756),AFP-AUC与VEGF-AUC相比差异无统计学意义(P0.05),p53抗体-AUC显著低于AFP-AUC与VEGF-AUC,差异有统计学意义(P0.01)。由ROC曲线可知,AFP、VEGF、p53抗体诊断HCC的最佳cut-off值分别为197μg/L、233 ng/L、0.63 k U/L,由此得知这3个指标诊断HCC的灵敏度、特异度分别为84.81%、87.59%,82.28%、89.78%,65.82%、86.13%。结论血清AFP与VEGF诊断HCC的临床性能相当,而p53抗体诊断HCC的灵敏度较低。

Clinical value of serum alpha fetoprotein,vascular endothelial growth factor,p53 antibody in diagnosis of primary hepatocellular carcinoma

Objective To evaluate the clinical value of serum alpha fetoprotein （AFP）, vascular endothe-lial growth factor （VEGF）, p53 antibody in diagnosis of primary hepatocellular carcinoma （HCC）. Methods Seventy nine patients with HCC （HCC group） from 2011 September to 2014 June in our hospital were selected, and 65 patients with liver cirrhosis （HC group） and 72 healthy subjects （HS group） served as control groups. AFP （measured by electrochemical luminescence method）, VEGF and p53 antibody （measured by ELISA） were determined in all participants. Results AFP, VEGF, p53 antibody were significantly higher in HCC group than that in HC group （P〈0.01）, and AFP, VEGF, p53 antibody were significantly higher in HC group than that in HS group （P〈0.01）. The drawing of the receiver operating characteristic （ROC） curve was made; we got the ROC curve area of AFP, VEGF, and p53 antibody for the diagnosis of HCC. AFP-AUC was 0.843 （95%CI, 0.738-0.905）, VEGF-AUC 0.827 （95%CI, 0.731-0.899）, and p53 antibody-AUC 0.634 （95%CI, 0.515-0.756）. After comparison, only p53 antibody-AUC was significantly lower than that of AFP-AUC and VEGF-AUC （P〈0.01）. By the ROC curves, the best cut-off values of AFP, VEGF, and p53 antibody in the diagnosis of HCC were 197 g/L, 233ng/L, and 0.63kU/L, respectively. The sensitivity and specificity in the di-agnosis of HCC were 84.81%and 87.59%for AFP, 82.28%and 89.78%for VEGF, 65.82%and 86.13%for p53 antibody, respectively. Conclusion The diagnostic power of serum AFP and VEGF for HCC was equiva-lent, and the sensitivity of p53 antibody in the diagnosis of HCC was lower.