甲胎蛋白、异常凝血酶原联合检测在肝细胞肝癌诊断中的临床意义

目的探讨血清肿瘤标志物甲胎蛋白（AFP）与异常凝血酶原（APT）联合检测在肝细胞肝癌（HCC）诊断中的临床意义。方法分别采用电化学发光法和酶联免疫法（ELISA）对48例HCC患者、34例肝硬化患者、30例体检健康者进行治疗前血清AFP和APT测定,并比较各组水平差异,用受试者工作特征曲线（ROC曲线）评价这两种血清标志物在诊断HCC中的临床价值。结果 HCC组、肝硬化组、正常组AFP测定值分别为（563.1±466.0）ng/mL、（18.7±10.4）ng/mL、（4.4±1.8）ng/mL,APT测定值分别为（707.2±415.4）mAU/mL、（25.4±8.7）mAU/mL、（11.8±2.6）mAU/mL,HCC组AFP、APT均高于其余两组（P〈0.05）。单独检测诊断HCC时,AFP的灵敏度和特异度分别为72.9%、76.5%,APT的灵敏度和特异度分别为68.8%、91.1%,二者联合检测的灵敏度和特异度分别为89.6%、94.1%。ROC曲线显示：APT单独检测诊断HCC的曲线下面积（0.908）大于AFP（0.838）,P〈0.01。结论 AFP与APT联合检测是区分HCC和肝硬化良好的血清学指标,能更好地用于HCC的临床早期诊断。

Clinical significance of combined detection of alpha fetoprotein and Abnormal prothrombin in the diagnosis of Hepatoceilular Carcinoma

Objective To explore the clinical significance of combined detection of AFP and APT in HCC. Methods Serum AFP and APT levels in 112 samples were detected by electrochemiluminescence and enzyme-linked immu- nosorbent assay （ELISA）,respectively. Among these samples,48 were with HCC, 34 were with cirrhosis, 30 were the normal healthy controls, and the differences between the levels were compared, and the clinical value of the two kinds of serum markers in the diagnosis of HCC were assessed by ROC analysis. Results The value of AFP were（563. 1 ± 466.0） ng/mL, （ 18.7±10.4） ng/mL, （ 4.4 ± 1.8） rig/mI, in the group of HCC, cirrhosis, healthy controls, respectively, and the APT value were（707.2±415.4）mAU/mL, （25.4±8.7）mAU/mL, （11.8±2.6）mAU/mL,respectively. Both AFP and APT levels in the group of HCC were higher than the other two groups （P〈0.05）. The sensitivity and speci ficity of AFP an APT was 72.9% ,76.5%,68.8%,91.1% ,respectively,and the sensitivity and specificity of combined detection was 89.6%,94. 1%. ROC curves indicated a better accuracy for APT （AUC 0. 908） than AFP （AUC= 0. 838） in diagnosis of HCC. Conclusion The combined detection of AFP and APT is a good serological indicator in distinguishing HCC from cirrhosis,which could be better applied to the early diagnosis of HCC.