血清spHBV联合AFP检测对HBV所致肝癌的预测价值

目的探讨血清HBV基因组剪接变异体(spHBV)联合甲胎蛋白(AFP)对HBV所致肝癌的预测价值。方法选择某院2018年1月~2018年12月收治的原发性肝癌和乙肝患者各46例(分别为肝癌组和非肝癌组)。采用ABI7600荧光定量PCR分析仪分别检测血清标本spHBV DNA和wtHBV DNA。血清spHBV即通过(spHBV DNA/wtHBV DNA)×100%来表示。采用化学发光法检测AFP。采用受试者工作特征(ROC)曲线评价血清spHBV及AFP单独或联合检测对肝癌的诊断效能。结果肝癌组血清spHBV及AFP明显高于非肝癌组(P<0.05)。血清spHBV及AFP单纯检测在肝癌患者诊断中最佳截点分别为11.66%、377.73 ng/ml,spHBV及AFP的ROC曲线下面积(AUC)分别为0.848,0.820,而联合检测其AUC高达0.947。spHBV单项指标检测原发性肝癌的敏感度和特异度分别为74.20%、93.55%;AFP单项指标检测原发性肝癌的敏感度和特异度分别为74.19%、77.40%;并联检测可将敏感度提高96.80%,串联可将特异度提高至100%。结论对于原发性肝癌的诊断血清spHBV较AFP而言具有较高的特异度,两者联合检测对原发性肝癌的诊断效能优于单项指标的检测,对肝癌的诊断具有较高的预测价值。

Joint detection of spliced variants of hepatitis B virus genomes and AFP caused by HBV-induced hepatocellular carcinoma

Objective To study the predictive value of spliced variants of hepatitis B virus genomes(spHBV)and alpha-Fetoprotein(AFP)for HBVinduced hepatocellular carcinoma.Methods 46 cases of primary hepatocellular carcinoma and 46 cases of hepatitis B patients admitted to our hospital from January2018 to December 2018(liver cancer group and non-liver cancer group respectively).ABI7600 fluorescence quantitative PCR was used to amplify and quantify spHBV and wtHBV DNA loads.Serum spHBV levels are expressed by(spHBVDNA/wtHBV DNA)*100%.The values of AFP in each group were detected by chemiluminescent immunoassay.Evaluation of serum spHBV and AFP alone or combined detection of hepatocellular carcinoma diagnosis efficiency by the receiver-operating characteristic(ROC)curve.Results The levels of serum spHBV and AFP in hepatocellular carcinoma group were significantly higher than that in non-hepatocellular carcinoma group(P<0.05).Serum spHBV and AFP in the diagnosis of hepatocellular carcinoma patients the best cutoff point is 11.66%,377.73 ng/ml respectively.The area under the ROC curve(AUC)was 0.848,0.820 respectively,while the AUC of the combined detection was as high as 0.947.The sensitivity and specificity of spHBV alone in the diagnosis of primary hepatocellular carcinoma were 74.20%and 93.55%respectively.The sensitivity and specificity of AFP alone in the diagnosis of primary hepatocellular carcinoma were 74.19%and 77.40%respectively.The sensitivity of parallel detection to 96.80%series could increase the specificity to 100%.Conclusion For the diagnosis of hepatocellular carcinoma,the serum spHBV has a higher specificity than AFP.The combined detection of the two is better than the detection of single index for the diagnosis of hepatocellular carcinoma,which has a high predictive value.