血清ALP、GGT、5’-NT与AFP联合检测在原发性肝癌诊断中的价值

目的探讨血清碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、5核苷酸酶(5’-NT)以及AFP单独检测以及联合检测在原发性肝癌(PHC)诊断中的临床应用价值。方法 ALP、GGT、5’-NT检测采用酶速率法;AFP检测用电化学发光免疫分析法,分别检测原发性肝癌组(94例)、肝硬化组(60例)、慢性肝炎组(60例)、其他消化道肿瘤组(50例)和健康对照组(70例)血清ALP、GGT、5’-NT、AFP水平,应用ROC曲线对结果进行统计学分析。结果 AFP、ALP、GGT、5’-NT的ROC曲线下面积(AUCROC)分别为0.832、0.649、0.786、0.774;AFP、5’-NT血清含量PHC组与其他各组间差异有统计学意义(P<0.05)。系列试验中,AFP+GGT+5’-NT组合的各个特征参数指标较好;平行试验中,AFP/GGT/5’-NT的灵敏度超过了97%。结论原发性肝癌诊断单项指标中以AFP的AUCROC最大,诊断价值最高;系列试验中以AFP+GGT+5’-NT作为确诊PHC,平行试验中以AFP/GGT/5’-NT作为排除PHC较好的组合项目。

Values of Combined Detection of Serum ALP, GGT, 5'-NT and AFP in the Diagnosis of Primary Hepatic Carcinoma

Objective To investigate the values of separate and combined detection of serum ALP, GGT, 5＇ - NT and AFP in the diagnosis of primary hepatic carcinoma （PHC）. Methods Serum ALP, GGT and 5＇ - NT were detected by enz- ymatic rate method. Serum AFP was determined by electrochemical luminescence immunoassay. Sera from 94 patients with PHC, 60 patients with cirrhosis, 60 cases with chronic hepatitis, 50 with other gastrointestinal tumors and 70 healthy individuals were subject to AFP, ALP, GGT and 5＇ - NT detection. The results were analyzed with ROC curves. Results The areas under the ROC curve （AUCR~C）of AFP, ALP, GGT and 5＇ - NT were 0.832, 0.649, 0. 786 and 0. 774, respectively. Serum AFP and 5＇ - NT levels in the PHC group were statistically different from those in other groups （P〈0.05）. In a series of tests, the combination of AFP , GGT and 5＇ - NT had fairly good characteristic parameters. In the parallel trial, the sensitivity of AFP/GGT/5＇ - NIT exceeded 97%. Conclusions For the individual indicators, AFP has the maximum AUC^ROC. It has the highest diagnostic value. For a series of tests, the combined detection of AFP, GGT and 5＇ - NT can be used to confirm PHC di- agnosis. For the parallel trial,AFP/GGT/5＇ - NT is the best combination to exclude PHC diagnosis.