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异常凝血酶原对肝细胞癌的诊断效能及其与肿瘤临床特征的相关性分析

刘智 杜晓宏 柴文刚

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异常凝血酶原对肝细胞癌的诊断效能及其与肿瘤临床特征的相关性分析

DOI: 10.12449/JCH241014
伦理学声明:本研究符合1964年《赫尔辛基宣言》的伦理标准并获得吉林大学第一医院伦理委员会审批,批号:AF-IRB-032-06。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:刘智负责收集数据资料,资料分析,撰写论文及修改论文;杜晓宏、柴文刚负责课题设计,拟定写作思路,指导撰写文章并最后定稿。
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    柴文刚, chaiwengang0@126.com (ORCID: 0009-0005-3935-6316)

Efficacy of des-γ-carboxy-prothrombin in the diagnosis of hepatocellular carcinoma and its association with the clinical features of hepatocellular carcinoma

More Information
  • 摘要:   目的  评估异常凝血酶原(DCP)在肝细胞癌(HCC)临床应用中的价值。  方法  回顾性分析2020年1月—2021年7月吉林大学第一医院收治的179例HCC患者的临床资料,另纳入207例健康对照者。应用磁微粒化学发光免疫分析法测定AFP及DCP血清学水平。绘制单独及联合检测时的受试者工作特征曲线(ROC曲线),并计算曲线下面积(AUC),探究联合应用DCP及AFP相较于单独检测AFP对HCC的临床诊断价值,以及DCP对AFP阴性患者的诊断效能。不符合正态分布的计量资料组间比较采用Mann-Whitney U检验。通过ROC曲线分析评估诊断效率。通过Spearman相关性分析明确肿瘤标志物与HCC病理学特征的相关性。  结果  HCC患者血清AFP和DCP水平较正常患者显著升高(Z值分别为-9.562、-11.678,P值均<0.05),DCP和AFP的联合检测优于AFP单独检测(Z=5.309,P<0.01)。DCP存在对AFP阴性HCC患者的诊断能力(AUC=0.789,P<0.000 1),敏感度和特异度分别为61.64%和86.47%。血清DCP水平与肿瘤大小(r=0.546,P<0.001)、TNM分期(r=0.306,P<0.001)、微血管侵犯(r=0.358,P<0.001)呈正相关,与肿瘤分化程度呈负相关(r=-0.220,P<0.05)。  结论  AFP、DCP的联合检测可提高HCC检出率且DCP可用于AFP阴性HCC患者的补充筛查;DCP的表达水平与HCC临床病理特征(包括肿瘤大小、TNM分期、微血管侵犯、肿瘤分化程度)之间存在相关性。

     

  • 图  1  HCC及对照组AFP、DCP测定

    Figure  1.  Determination of AFP and DCP in HCC and control group

    图  2  DCP和AFP作为单独及联合检测标志物在HCC诊断中的ROC分析

    Figure  2.  ROC analysis of DCP and AFP as single and combined markers in the diagnosis of HCC

    图  3  DCP在诊断AFP阴性HCC患者中的ROC分析

    Figure  3.  ROC analysis of DCP in the diagnosis of AFP negative HCC patients

    表  1  AFP、DCP及联合诊断的效能评估

    Table  1.   Effectiveness evaluation of AFP, DCP and combined diagnosis

    指标 AUC Cut-off值 敏感度(%) 特异度(%) Z P
    AFP 0.782(0.738~0.822) 7.28 58.66(51.34~65.62) 98.55(95.83~99.60)
    DCP 0.845(0.804~0.879) 44.75 64.25(56.99~70.90) 93.24(88.97~95.93) 2.079 0.037 61)
    AFP+DCP 0.884(0.847~0.914) 78.77 93.72 5.309 <0.000 12)

    注:与AFP组相比较,1)P<0.05;2)P<0.01。

    下载: 导出CSV

    表  2  DCP与HCC临床特征相关性分析

    Table  2.   Correlation analysis between DCP and clinicopathological features of HCC

    指标 r P
    年龄 -0.092 0.220

    性别

    AFP

    0.001

    0.264

    0.991

    <0.001

    肿瘤大小 0.546 <0.001
    肿瘤数目 -0.046 0.543
    TNM分期 0.306 <0.001
    分化程度 -0.220 0.005
    微血管侵犯 0.358 <0.001
    卫星灶 0.089 0.237
    下载: 导出CSV
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  • 收稿日期:  2024-02-19
  • 录用日期:  2024-03-11
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