凝血酶敏感蛋白-1和甲胎蛋白检测对肝癌的诊断价值

【目的】探讨肝癌患者血清中凝血酶敏感蛋白-1（TSP-1）表达水平及联合检测TSP-1和甲胎蛋白（AFP）在肝癌诊断中的应用价值。【方法】检测临床已确诊的肝癌组患者48例，肝纤维化组患者43例，健康对照组40例血清中的TSP-1和AFP的水平，比较各组差异及两者对肝癌诊断的灵敏度及特异性；采用受试者工作特征曲线（ROC曲线）分析TSP-1和AFP最佳诊断界值，同时分析TSP-1和AFP联合检测对肝癌的诊断价值。【结果】①肝癌组TSP-1的水平明显低于肝纤维化组和健康对照组，肝纤维化组低于健康对照组（P〈0．01）；肝癌组AFP的水平明显高于肝纤维化组和健康对照组（P〈0．01）；②单独检测TSP-1诊断肝癌的灵敏度为79．17％（38／48），特异度为78．31％（65／83）；单独检测AFP诊断肝癌的灵敏度为58．33％（28／48），特异度为79．52%（66／83）；③TSP-1、AFP串联检测诊断肝癌的灵敏度为43．75％（21／48），特异度为95．18％（79／83）；TSP-1、AFP并联检测时诊断肝癌的灵敏度为93．75％（45／48），特异度为62．65％（52／83）。【结论】血清TSP-1水平可作为肝癌诊断的一个新的标志物，且TSP-1单独检测诊断肝癌时灵敏度与特异度均较高，有利于肝癌的早期诊断；TSP-1与AFP联合检测可以提高肝癌检测的灵敏度与特异性。

TSP-1 Levels in Serum to the Diagnosis of Hepatic Carcinoma

Objective]To explore the expression levels of Thrombospondin-1(TSP-1)in the serum of patients with hepatic carcinoma,and the application values of TSP-1 combined with alpha-fetoprotein (AFP)in the diagno-sis of hepatic carcinoma (HCC).Methods]Selected 48 cases of clinically diagnosed HCC patients,43 cases of he-patic fibrosis,and 40 cases of normal healthy perple as the control group.Detection of TSP-1 used the sandwich enzyme immunoassay technique,and detection of AFP used Chemiluminescence.A statistical analysis of TSP-1 and AFP was performed to show the differences between groups,and both the sensitivity and the specificity of di-agnosis to hepatic carcinoma.The best diagnostic value of TSP-1 and AFP was defined by the ROC curve.An anal-ysis of the diagnostic value of combined detection of TSP-1 and AFP in hepatic carcinoma was performed.Result]1 .TSP-1 in group of hepatic carcinoma was significantly lower than group of hepatic fibrosis and normal control group.The group of hepatic fibrosis was lower than the group of normal control.AFP in the group of hepatic carci-noma was significantly higher than in the group of hepatic fibrosis and group of normal control.2.To measure TSP-1 respectively,the sensitivity of diagnosis to hepatic carcinoma was 79.17%(38/48)and the specificity was 78.31%(65/83).3.To measure AFP respectively,the sensitivity of diagnosis to hepatic carcinomas was 58.33%(28/48)and the specificity was 79.52%(66/83).4.The sensitivity of the serial test of TSP-1 and AFP to the diag-nosis of hepatic carcinoma was 43.75% (21/48)and the specificity was 95.18% (79/83).The sensitivity of the parallel test of TSP-1 and AFP to the diagnosis of hepatic carcinoma was 93.75% (45/48)and the specificity was 62.65% (52/83).Conclusions]The levels of TSP-1 in serum can be used as a new marker for hepatic carcinoma and both the sensitivity and the specificity of measuring TSP-1 ,respectively,were high in the diagnosis of hepatic carcinoma.It is very beneficial to the early diagnosis of hepatic carcinoma.Combined detection of TSP-1 and AFP can improve the sensitivity and specificity in diagnosis of hepatic carcinoma.