摘要
目的 探讨甲胎蛋白异质体L3(alpha-fetoprotein variants L3,AFP-L3)和维生素K缺乏或拮抗剂-Ⅱ诱导的蛋白质(protein induced by vitamin K absence or antagonist Ⅱ,PIVKAⅡ)在肝癌诊断中的的价值。方法 收集2019年1月至2022年1月期间青岛市第六人民医院收治的3 066例患有慢性肝脏疾病患者作为研究对象。比较AFP-L3、PIVKAⅡ、CK65、CK30、TK1在肝炎、肝硬化以及肝癌间的水平差异,评估特异性、敏感度,应用受试者工作特征曲线(receiver operating characteristic,ROC)曲线评估生物标志物及提出最优截断点。结果 AFP-L3和PIVKA在肝硬化组中表达高于肝炎组(P <0.000 1),CK65、CK30和TK在肝硬化组中表达低于肝炎组(P <0.001)。肝癌组中AFP-L3、CK65、CK30和PIVKA表达显著高于肝硬化组(P <0.000 1),TK在肝癌组中的表达低于肝硬化组(P> 0.05)。在纳入研究的5种生物标志物中,AFP-L3具有最高的特异度(0.89),PIVKAⅡ具有最高的灵敏度(0.62),且联合应用AFP-L3和PIVKAⅡ灵敏度达到0.70,特异度达到0.81,有相较于单个标志物更优的表现。ROC曲线分析表明PIVKAⅡ具有更高的诊断价值(24)。结论 在肝癌筛查中AFP-L3比PIVKAⅡ特异性高,联合AFP-L3和PIVKAⅡ诊断可其在肝癌中的诊断价值。
Objective To investigate the diagnostic value of AFP-L3 and PIVKAⅡin liver cancer.Methods A total of 3066 patients with chronic liver disease who were admitted to Qingdao Sixth People’s Hospital from January 2019 to January 2022 were selected as objects of the research.The levels of AFP-L3,PIVKAⅡ,CK65,CK30,and TK1 in hepatitis,liver cirrhosis,and liver cancer were compared.The specificity and sensitivity were evaluated,and the ROC curve was used to evaluate the biomarkers and propose the optimal cutoff point.Results The expression of AFP-L3 and PIVKA in the liver cirrhosis group was higher than that in the hepatitis group(P<0.0001),while the expression of CK65,CK30,and TK in liver cirrhosis group was lower than that in the hepatitis group(P<0.001).The expression of AFP-L3,CK65,CK30 and PIVKA in the liver cancer group was significantly higher than that in the liver cirrhosis group(P<0.0001),while the expression of TK in the liver cancer group was lower than that in the liver cirrhosis group(P>0.05).Among the five biomarkers included in the study,AFP-L3 had the highest specificity(0.89)and PIVKAⅡhad the highest sensitivity(0.62),and the combined application of AFP-L3 and PIVKAⅡhad a sensitivity of 0.70 and a specificity of 0.81,which was better than a single marker.The analysis of ROC curve showed that PIVKAⅡhad a higher diagnostic value(24).Conclusion AFP-L3 is more specific than PIVKAⅡin liver cancer screening,and the combination of AFP-L3 and PIVKAⅡdiagnosis may have diagnostic value in liver cancer.
作者
兰立强
李静
任清波
LAN Liqiang;LI Jing;REN Qingbo(Dept of General Internal Medicine,Qingdao Sixth People’s Hospital,Qingdao Shandong 266000,China;Dept.of Clinical Laboratory,Qingdao Sixth People’s Hospital,Qingdao Shandong 266000,China)
出处
《昆明医科大学学报》
CAS
2023年第7期136-141,共6页
Journal of Kunming Medical University
基金
山东省医药卫生科技发展计划项目(202203080166)。
