摘要
目的探讨中国GALAD(C-GALAD)评分系统在肝细胞癌(HCC)诊断中的临床应用价值。方法收集2020年3月至2021年3月于郑州人民医院就诊的HCC患者98例(HCC组)、良性肝病患者90例(肝病组)及体检健康者50例(健康人对照组)。检测受试者血清甲胎蛋白(AFP)、甲胎蛋白异质体-L3(AFP-L3)以及异常凝血酶原(DCP)水平,并计算C-GALAD评分;比较各组间AFP、AFP-L3、DCP及C-GALAD评分差异,采用ROC曲线分析各指标对HCC的诊断及鉴别价值。结果HCC组与肝病组AFP(分别为283.50±83.43μg/L、102.65±26.51μg/L)、AFP-L3[分别为(14.90±3.74)%、(8.69±2.6)%]、DCP(分别为263.74±53.71 mAU/mL、83.62±16.59 mAU/mL)、C-GALAD评分(分别为4.02±1.05、0.67±0.21)均显著高于健康人对照组[分别为10.16±2.52μg/L、(5.30±2.01)%、18.76±2.17 mAU/mL和-1.23±0.57],且HCC组均高于肝病组(P<0.05);C-GALAD评分定量诊断HCC、鉴别HCC与肝病的ROC曲线下面积(AUC^(ROC)分别为0.875、0.917)均显著高于单独AFP、AFP-L3、DCP(分别为0.808和0.787、0.821和0.869、0.845和0.856);Ⅲ/Ⅳ组HCC患者AFP(397.13±70.68μg/L)、AFP-L3(19.20±3.46)%、DCP水平(386.14±65.07 mAU/mL)及C-GALAD评分(6.28±1.73)均显著高于Ⅰ/Ⅱ组[214.51±47.57μg/L、(13.23±3.59)%、186.33±51.42 mAU/mL、2.75±0.79,P均<0.05],且C-GALAD评分诊断HCC病理分期的AUC^(ROC)(0.917)高于单独AFP、AFP-L3、DCP(分别为0.804、0.795、0.804)。结论C-GALAD评分可用于HCC的鉴别诊断,其性能优于传统单一生化指标AFP、AFP-L3、DCP。
Objective To investigate the application value of Chinese GALAD(C-GALAD)scoring system in the diagnosis of hepatocellular carcinoma(HCC).Methods Ninety-eight HCC patients,90 patients with benign liver disease and 50 healthy controls were collected from Zhengzhou People′s Hospital during March 2020 and March 2021.Their serum alpha-fetal protein(AFP),alpha-fetoprotein L3(AFP-L3)and Des-gamma-carboxy prothrombin(DCP)levels were detected and the C-GALAD scores were calculated.The differences of AFP,AFP-L3,DCP and C-GALAD scores among different groups were compared,and the diagnostic and differential values of each index for HCC were analyzed by the ROC curve.Results The levels of serum AFP,AFP-L3 and DCP and C-GALAD scores in HCC patients([283.50±83.43]μg/L,[14.90±3.74]%,[263.74±53.71]mAU/mL and 4.02±1.05)and patients with benign liver disease([102.65±26.51]μg/L,[8.69±2.6]%,[83.62±16.59]mAU/mL and 0.67±0.21)were significantly higher than those in healthy controls([10.16±2.52]μg/L,[5.30±2.01]%,[18.76±2.17]mAU/mL and-1.23±0.57),and those in HCC patients were significantly higher than those in patients with benign liver disease(P<0.05).The areas under the ROC curve(AUC^(ROC))of C-GALAD score for the diagnosis of HCC and distinguishing HCC from benign liver disease were 0.875 and 0.917,respectively,which were significantly higher than those of serum AFP(0.808 and 0.869),AFP-L3(0.787 and 0.845)and DCP(0.821 and 0.856).The levels of serum AFP,AFP-L3 and DCP and C-GALAD scores in HCC patients with TNM stageⅢ/Ⅳ([397.13±70.68]μg/L,[19.20±3.46]%,[386.14±65.07]mAU/mL and 6.28±1.73)were significantly higher than those with TNM stageⅠ/Ⅱ([214.51±47.57]μg/L,[13.23±3.59]%,[186.33±51.42]mAU/mL and 2.75±0.79,P<0.05).The AUCROC of C-GALAD score(0.917)in the diagnosis of HCC pathological stage was significantly higher than that of serum AFP(0.804),AFP-L3(0.795)and DCP(0.804).Conclusion C-GALAD score can be used in the differential diagnosis of HCC,and its performance is better than traditional biochemical indexes such as AFP,AFP-L3 and DCP.
作者
齐莹莹
林琳
QI Yingying;LIN Lin(Department of Clinical Laboratory,Zhengzhou People′s Hospital,Zhengzhou 450000,Henan;Department of Clinical Laboratory,Henan Cancer Hospital,Zhengzhou 450000,Henan,China)
出处
《临床检验杂志》
CAS
2021年第12期915-919,共5页
Chinese Journal of Clinical Laboratory Science
