Hu R Z, Zhao S Q, Shen B, Guo G B
Department of Clinical Laboratory, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China.
Zhonghua Gan Zang Bing Za Zhi. 2019 Aug 20;27(8):634-637. doi: 10.3760/cma.j.issn.1007-3418.2019.08.009.
To explore the diagnostic value of single or combined detection of serum tumor markers alpha-fetoprotein (AFP), α-fetoprotein (AFP)-L3 and abnormal clotting (PIVKA-II) in the primary hepatic carcinoma. Serum AFP, AFP-L3 and PIVKA-II of 56 cases with primary hepatic carcinoma, 46 cases with cirrhosis, 45 cases with other liver disease and 41 healthy persons (control group) were examined by chemiluminescence method, and the differences in the levels of AFP, AFP-L3 and PIVKA-II in each group were compared. Serum level of AFP, AFP-L3 and PIVKA-II in patients with primary liver cancer was significantly higher than that of the cirrhosis, other liver disease and control groups, and the difference was statistically significant ( < 0.05). The receiver operating characteristic curve analysis showed that the areas under the curve for the diagnosis of primary hepatic carcinoma by AFP, AFP-L3 and PIVKA-II were 0.887, 0.846 and 0.885, respectively. The combined use of the three tumor markers for the diagnosis of primary hepatic carcinoma increased the area under the curve to 0.899. Among the single detection, AFP had the highest sensitivity of 91.07% and PIVKA-II had the highest specificity at 88.63%. In the combined detection, AFP/PIVKA-II combination had the highest sensitivity of 94.64 %, while the AFP + AFP-L3 + PIVKA-II combination had the highest specificity at 98.48%. Combined detection of AFP, AFP-L3 and PIVKA-II could improve the diagnostic specificity and the sensitivity of primary hepatic carcinoma; thereby make up the deficiency of single detection and improve the early diagnosis rate.
探讨血清肿瘤标志物甲胎蛋白（AFP）、甲胎蛋白异质体（AFP-L3）和异常凝血酶原（PIVKA-II）单项及联合检测在原发性肝癌中的诊断价值。采用化学发光法检测56例原发性肝癌患者、46例肝硬化患者、45例其他肝病患者及41例健康人（对照组）的血清AFP、AFP-L3和PIVKA-II，比较各组AFP、AFP-L3和PIVKA-II水平的差异。原发性肝癌患者血清AFP、AFP-L3和PIVKA-II水平显著高于肝硬化组、其他肝病组及对照组，差异有统计学意义（<0.05）。受试者工作特征曲线分析显示，AFP、AFP-L3和PIVKA-II诊断原发性肝癌的曲线下面积分别为0.887、0.846和0.885。三项肿瘤标志物联合检测诊断原发性肝癌可使曲线下面积增至0.899。单项检测中，AFP灵敏度最高，为91.07%，PIVKA-II特异性最高，为88.63%。联合检测中，AFP/PIVKA-II联合灵敏度最高，为94.64%，而AFP+AFP-L3+PIVKA-II联合特异性最高，为98.48%。AFP、AFP-L3和PIVKA-II联合检测可提高原发性肝癌诊断的特异性和灵敏度，弥补单项检测不足，提高早期诊断率。
