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AFP联合GGT/AST对HBV相关肝细胞癌的诊断价值

蔡馨 陈娟娟 汤冬玲 张平安

蔡馨, 陈娟娟, 汤冬玲, 等. AFP联合GGT/AST对HBV相关肝细胞癌的诊断价值[J]. 临床肝胆病杂志, 2021, 37(9): 2109-2112. DOI: 10.3969/j.issn.1001-5256.2021.09.021
引用本文: 蔡馨, 陈娟娟, 汤冬玲, 等. AFP联合GGT/AST对HBV相关肝细胞癌的诊断价值[J]. 临床肝胆病杂志, 2021, 37(9): 2109-2112. DOI: 10.3969/j.issn.1001-5256.2021.09.021
CAI X, CHEN JJ, TANG DL, et al. Value of alpha-fetoprotein combined with gamma-glutamyl transpeptidase/aspartate aminotransferase ratio in diagnosis of HBV-associated hepatocellular carcinoma[J]. J Clin Hepatol, 2021, 37(9): 2109-2112. DOI: 10.3969/j.issn.1001-5256.2021.09.021
Citation: CAI X, CHEN JJ, TANG DL, et al. Value of alpha-fetoprotein combined with gamma-glutamyl transpeptidase/aspartate aminotransferase ratio in diagnosis of HBV-associated hepatocellular carcinoma[J]. J Clin Hepatol, 2021, 37(9): 2109-2112. DOI: 10.3969/j.issn.1001-5256.2021.09.021

AFP联合GGT/AST对HBV相关肝细胞癌的诊断价值

DOI: 10.3969/j.issn.1001-5256.2021.09.021
基金项目: 

国家自然科学基金 81773444

湖北省自然科学基金 2019CFC846

详细信息
    通讯作者:

    张平安,zhangpingan927@163.com

  • 中图分类号: R512.62;R735.7

Value of alpha-fetoprotein combined with gamma-glutamyl transpeptidase/aspartate aminotransferase ratio in diagnosis of HBV-associated hepatocellular carcinoma

Funds: 

National Natural Science Foundation of China 81773444

Hubei Provincial Natural Science Foundation of China 2019CFC846

  • 摘要:   目的  探讨AFP联合GGT/AST在HBV相关肝细胞癌(HCC)中的临床诊断价值。  方法  选取2019年1月15日—6月15日于武汉大学人民医院诊治的慢性乙型肝炎患者(CHB组)、乙型肝炎肝硬化患者(LC组)、HBV相关HCC患者(HCC组)和健康体检者(HC组)共352例,其中HC组86例,CHB组68例,LC组69例,HCC组129例,回顾性分析所有研究对象血清学检测数据。正态分布计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验。偏态分布计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Nemenyi法检验。通过二元logistic回归分析计算出预测变量,并绘制AFP、GGT/AST以及预测变量单独或联合检测的受试者工作特征曲线(ROC曲线),计算曲线下面积(AUC)及敏感度、特异度,采用Z检验对AUC进行比较。  结果  HCC组GGT/AST和AFP水平均显著高于其他组(P值均<0.05)。ROC曲线分析结果显示,在HCC组与LC组、HCC组与HC组+CHB组+LC组、HCC组与CHB组+LC组中,AFP与GGT/AST联合诊断的AUC均明显高于AFP单独诊断的AUC(Z值分别为2.684、2.241、2.415,P值分别为0.007、0.025、0.016)。  结论  AFP联合GGT/AST可提高HBV相关HCC的临床诊断性能,具有一定诊断价值。

     

  • 图  1  AFP与GGT/AST单独或联合检测诊断HCC的ROC曲线

    注:a,HCC组与CHB组; b,HCC组与LC组; c,HCC组与HC组+CHB组+LC组; d,HCC组与CHB组+LC组。

    表  1  各组AFP、GGT、AST及GGT/AST血清学水平比较

    组别 例数 AFP(ng/ml) GGT/AST GGT(U/L) AST(U/L)
    HC组 86 3.35(2.20~4.70) 0.98(0.71~1.36) 20.00(15.00~27.00) 21.00(18.00~24.00)
    CHB组 68 4.35(2.35~15.75) 0.82(0.46~1.25) 51.00(23.75~140.75)1) 61.00(34.25~125.00)1)
    LC组 69 8.60(2.70~54.20)1) 0.97(0.55~1.81) 69.00(27.00~113.00)1) 47.00(31.00~88.00)1)
    HCC组 129 157.10(9.90~6126.40)1)2)3) 2.00(1.19~3.11)1)2)3) 98.00(45.00~207.00)1)2)3) 46.00(29.00~88.00)1)2)
    H 124.018 70.202 126.282 135.987
    P <0.001 <0.001 <0.001 <0.001
    注:与HC组比较,1)P<0.05;与CHB组比较,2)P<0.05;与LC组比较,3)P<0.05。
    下载: 导出CSV

    表  2  AFP与GGT/AST单独或联合检测在辅助HCC诊断中的价值

    分组 标志物 AUC 95%CI 敏感度(%) 特异度(%) P
    HCC组vs CHB组 AFP 0.803 0.742~0.864 72.9 72.1 <0.05
    GGT/AST 0.789 0.717~0.861 67.4 83.8 <0.05
    联合 0.846 0.790~0.910 79.8 77.9 <0.05
    HCC组vs LC组 AFP 0.760 0.693~0.826 55.8 84.1 <0.05
    GGT/AST 0.727 0.650~0.803 90.7 46.4 <0.05
    联合 0.802 0.741~0.862 48.1 97.1 <0.05
    HCC组vs HC组+CHB组+LC组 AFP 0.835 0.791~0.879 86.0 68.2 <0.05
    GGT/AST 0.768 0.718~0.817 67.4 74.9 <0.05
    联合 0.843 0.802~0.885 73.6 78.5 <0.05
    HCC组vs CHB组+LC组 AFP 0.781 0.727~0.835 55.8 85.4 <0.05
    GGT/AST 0.758 0.700~0.815 67.4 77.5 <0.05
    联合 0.823 0.775~0.871 81.4 66.4 <0.05
    下载: 导出CSV
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  • 收稿日期:  2021-01-09
  • 修回日期:  2021-04-02
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