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肝细胞癌患者GGT和甲胎蛋白的表达水平及相关性分析
Expression and correlation analysis of γ-glutamyl transpeptidase and alpha-fetoprotein in patients with hepatocellular carcinoma
文章发布日期:2015年08月11日  来源:  作者:白利青,乔佳妮  点击次数:1772次  下载次数:289次

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【摘要】:目的探讨GGT和甲胎蛋白(AFP)在肝细胞癌(HCC)患者组织中的表达水平及相关性,评价其在HCC临床诊断中的应用价值。方法选择2011年12月-2014年12月在榆林市星元医院就诊的HCC患者84例和肝硬化患者76例,分析不同组别AFP和GGT表达水平的差异和相关性,并依据敏感性、特异性、约登指数、受试者工作特征曲线(ROC)和曲线下面积(AUC)确定诊断界值点。两组间比较采用独立样本t检验或Mann-Whitney U检验。相关性比较采用Spearman秩相关分析。结果HCC组患者AFP和GGT的表达水平均高于肝硬化组,差异有统计学意义(Z值分别为-8.993、-7.647,P值均<0.05)。HCC组和肝硬化组患者AFP和GGT的表达水平均存在正相关关系(rs值分别为0.531、0.416,P值均<0.05);所有受试者AFP水平和GGT的表达存在正相关关系(rs=0.701,P<0.05)。AFP和GGT对HCC的诊断准确性一般。AFP取界值为100 ng/ml时,其约登指数最大为0.519;GGT取界值为150 U/L时,约登指数最大为0.494。AFP和GGT联合诊断能够增加灵敏度、降低特异度,但是没有明显改变AFP诊断HCC的约登指数。结论GGT和AFP 的表达水平存在明显的正相关关系,但是AFP和GGT联合检测并没有显著改善HCC诊断的准确性。
【Abstract】:Objective To analyze the expression levels of γ-glutamyl transpeptidase (GGT) and alpha-fetoprotein (AFP) and their correlation in patients with hepatocellular carcinoma (HCC) and to evaluate their diagnostic values for HCC. Methods A total of 160 patients consisting of 84 cases of HCC and 76 cases of liver cirrhosis, who were examined in the department of clinical laboratory, Yulin Xingyuan hospital, from December 2011 to December 2014, were selected in this study. The difference and correlation of AFP and GGT expression levels in the two groups were analyzed. The diagnostic cut-off values were determined based on sensitivity, specificity, Youden′s index, receiver operating characteristic (ROC) curve, and area under the ROC curve. Comparison between two groups was made by independent-samples t test or Mann-Whitney U test. The correlation between AFP and GGT was determined by Spearman rank correlation analysis. Results The AFP and GGT expression levels in the HCC group were significantly higher than those in the cirrhosis group (Z=-8.993, P<0.05; Z=-7.647, P<0.05). The expression levels of AFP and GGT in both groups were positively correlated (rs=0.531, P<0.05; rs=0.416, P<0.05). There was also a positive correlation between the AFP and GGT expression levels for all the subjects (rs=0.701, P<0.05). The diagnostic accuracy of AFP and GGT for HCC was moderate. The maximum Youden′s index was 0.519 for AFP when its cut-off value was 100 ng/ml and the maximum Youden′s index was up to 0.494 for GGT when its cut-off value reached 150 U/L. A combination of AFP and GGT could increase the sensitivity and decrease the specificity in the diagnosis of HCC, but no significant change in the Youden′s index for AFP was observed. Conclusion There is a significant positive correlation between the expression levels of GGT and AFP, but the combined measurement of AFP and GGT does not improve the accuracy of HCC diagnosis.
【关键字】:癌,肝细胞;γ-谷氨酰转移酶;甲胎蛋白类;诊断
【Key words】:carcinoma, hepatocellular; gamma-glutamyltransferase; alpha-fetoproteins; diagnosis
【引证本文】:白利青, 乔佳妮. 肝细胞癌患者GGT和甲胎蛋白的表达水平及相关性分析[J]. 临床肝胆病杂志, 2015, 31(9): 1452-1454.

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