血清AFP临界值判断对肝癌诊断的影响

广西师范大学学报（自然科学版） ›› 2014, Vol. 32 ›› Issue (3): 121-124.

血清AFP临界值判断对肝癌诊断的影响

霍群¹, 刘杰², 陈莉¹, 廖维甲³

1.桂林医学院生物化学与分子生物学教研室,广西桂林541004;
2.桂林医学院附属医院肝胆胰外科,广西桂林541004;
3.桂林医学院附属医院肝胆胰外科实验室,广西桂林541004

收稿日期:2014-02-25 出版日期:2014-09-25 发布日期:2018-09-25
通讯作者: 霍群(1970—),女,广西桂林人,桂林医学院副教授。E-mail:446358749@qq.com
基金资助:
广西自然科学基金资助项目(2010GXNSFC013023);国家自然科学基金资助项目(81260328)

Influence of Cut-off Value of AFP on Diagnosis of Hepatic Cancer

HUO Qun¹, LIU Jie², CHEN Li¹, LIAO Wei-jia³

1. Department of Biochemistry, Guilin Medical University,Guilin Guangxi 541004, China;
2. Hepatopancreatobiliary Surgery, Guilin Medical University Affiliated Hospital, Guilin Guangxi 541004, China;
3. Hepatopancreatobiliary Surgery Laboratory, Guilin Medical University Affiliated Hospital, Guilin Guangxi 541004, China

Received:2014-02-25 Online:2014-09-25 Published:2018-09-25

摘要/Abstract

摘要： 为探讨血清AFP诊断肝癌的合理临界值,本研究收集肝癌患者35例、正常对照者35例。血清AFP检测采用电化学发光法和酶联免疫吸附法(ELISA)定量,结果用t检验和χ²检验进行统计学分析。2种方法检测血清AFP水平显著相关,相关系数为0.978,检测值无显著性差异,P>0.05。二者ROC曲线下面积分别为0.890、0.880,说明血清AFP水平对肝癌诊断价值较高。按照约登指数最大原则确定血清AFP电化学发光法诊断肝癌的临界值为3.25 μg/L,其敏感度为74.3%,特异度为94.3%,准确度为84.3%;ELISA法诊断肝癌的临界值为1.118 μg/L,其敏感度为62.9%,特异度为100%,准确度为81.4%。而以目前常规临界值20 μg/L来分析,则电化学发光法检测AFP诊断肝癌的敏感度仅为45.7%,特异度100%,准确度72.9%;ELISA法敏感度48.6%,特异度100%,准确度74.3%。因此合理降低临界值可有效提高血清AFP水平对肝癌的诊断价值。

关键词: 肝癌, AFP, 临界值

Abstract: To analyze a reasonable cut-off value of serum AFP in hepatic cancer diagnosis, 35 cases of hepatic cancer patients and 35 healthy people were chosen as the samples. Electrochemiluminescence immunoassay (ECLIA) and enzyme-1inked immunosorbent assay (ELISA) are used to collect serum samples and analyze AFP levels. SPSS 18.0 software was used for statistical analysis. The correlation coefficient is 0.978, showing the results by ECLIA were significantly correlated to those by ELISA. They had no significant difference, P＞0.05. The area under the ROC curve was 0.890, 0.880 respectively by these two methods. The sensitivity, specificity and accuracy were 74.3%, 94.3%, 84.3% by ECLIA if taking 3.25 μg/L as cut-off value and 62.9%, 100%, 81.4% by ELISA if taking 1.118 μg/L as cut-off value. Whereas if taking 20 μg/L as cut-off value, the sensitivity and accuracy were only 45.7%, 72.9% by ECLIA and 48.6%, 74.3% by ELISA. So decreasing cut-off value of serum AFP can improve the diagnosis value of hepatic cancer effectively.

Key words: hepatic cancer, AFP, cut-off value

中图分类号:

R446.61

霍群, 刘杰, 陈莉, 廖维甲. 血清AFP临界值判断对肝癌诊断的影响[J]. 广西师范大学学报（自然科学版）, 2014, 32(3): 121-124.

HUO Qun, LIU Jie, CHEN Li, LIAO Wei-jia. Influence of Cut-off Value of AFP on Diagnosis of Hepatic Cancer[J]. Journal of Guangxi Normal University(Natural Science Edition), 2014, 32(3): 121-124.

参考文献

[1] PARKIN D M, BRAY F, FERLAY J, et al. Global cancer statistics 2002[J]. CA:A Cancer Journal for Clinicians, 2005, 55(2):74-108.
[2] 杨秉辉, 丛文铭, 周晓军. 原发性肝癌规范化诊治专家共识[J]. 临床肿瘤学杂志, 2009, 14(3):259-269.
[3] RANDEEP K, ASHOK J, MICHAEL N, et al. Clinical signiﬁcance of elevated α-fetoprotein in adults and children[J]. Digestive Diseases and Sciences, 2001, 46(8):1709-1713.
[4] XU Xiao, KE Qing-hong, SHAO Zhe-xin, et al. The value of serum α-fetoprotein in predicting tumor recurrence after liver transplantation for hepatocellular carcinoma[J]. Digestive Diseases and Sciences, 2009, 54(2):385-388.
[5] GOSHI S, NORIMASA M. Biomarkers for hepatocellular carcinoma[J]. Clinical Journal of Gastroenterology, 2012, 5(3):177-182.
[6] HUANG JEE-FU, KENICHI T, SHUICHI O, et al. Primary hepatocellular carcinoma detected long after tumor markers and lymph node metastases-beyond our vision?[J]. Digestive Diseases and Sciences, 2006, 51(3):610-615.
[7] HU Jin-song, WU De-wu, LIANG Shuo, et al. GP73, a resident Golgi glycoprotein, is sensibility and specificity for hepatocellular carcinoma of diagnosis in a hepatitis B-endemic Asian population[J]. Medical Oncology, 2010, 27(2):339-345.
[8] CARMEN A, JORDI R. Imaging of HCC[J]. Abdominal Imaging, 2012, 37(2):215-230.
[9] CAROLINE D M W, SUSANNA M van A, EWOUT W S, et al. Recently introduced biomarkers for screening of hepatocellular carcinoma:a systematic review and meta-analysis[J]. Hepatology International, 2013, 7(1):59-64.
[10] HSIA C Y, HUO T I, CHIANG S Y, et al. Evaluation of interleukin-6, interleukin-10 and human hepatocyte growth factor as tumor markers for hepatocellular carcinoma[J]. European Journal of Surgical Oncology, 2007, 33(2):208-212.
[11] GIANNELLI G, FRANSVEA E, TREROTOLI P, et al. Clinical validation of combined serological biomarkers for improved hepatocellular carcinoma diagnosis in 961 patients[J]. Clinica Chimica Acta, 2007, 383(1/2):147-152.
[12] PORTA C, DE AMICI M, QUAGLINI S, et al. Circulating interleukin-6 as a tumor marker for hepatocellular carcinoma[J]. Annals of Oncology, 2008, 19(2):353-358.
[13] HUSSEIN M M, IBRAHIM A A, ABDELLA H M, et al. Evaluation of serum squamous cell carcinoma antigen as a novel biomarker for diagnosis of hepatocellular carcinoma in Egyptian patients[J]. Indian Journal of Cancer, 2008, 45(4):167-172.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed