摘要【目的】探讨铁蛋白(FER)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)对肝癌诊断、疗效评估的价值。【方法】本院收治的肝癌患者80例作为肝癌组,选取同期收治的良性肝脏病患者80例作为良性肝病组。所有患者均于入院当日检测FER、AFP和AFP-L3水平,分析各指标对肝癌的诊断价值。肝癌患者均接受射频消融术治疗,于术后1个月分析血清FER、AFP、AFP-L3水平对疗效的评估价值。【结果】肝癌组血清FER、AFP、AFP-L3含量显著高于良性肝病组( P >0.05)。FER、AFP、AFP-L3单独诊断肝癌的灵敏度分别为72.50%、77.50%、81.25%,特异度分别为78.75%、87.50%、86.25%,准确率分别为75.63%、82.50%、83.75%,经Kappa检验其与病理诊断一致性分别为0.513、0.650、0.675。FER+AFP+AFP-L3联合诊断肝癌的灵敏度为90.00%,特异度为92.50%,准确率为91.25%,与病理诊断一致性为0.825。在80例肝癌中,有65例治疗有效,总缓解率为81.25%。有效组血清FER、AFP、AFP-L3含量显著低于无效组( P >0.05)。FER、AFP、AFP-L3单独评估肝癌疗效的ROC曲线下面积(AUC)分别为0.671、0.688、0.716,FER+AFP+AFP-L3联合评估的AUC为0.797。【结论】血清FER、AFP、AFP-L3对肝癌的诊断与疗效评估均有一定价值,以联合评估的效果最好。
Abstract：【Objective】To explore the application value of ferritin (FER), alpha fetoprotein (AFP), alpha fetoprotein-L3 (AFP-L3) in the diagnosis and evaluation of curative effect of hepatocellular carcinoma (HCC). 【Methods】A total of 80 patients with HCC were selected as the HCC group. And 80 patients with benign liver disease were selected as benign liver disease group. The levels of FER,AFP,AFP-L3 were measured on the day of admission, and the diagnostic value of each index for HCC was analyzed. All patients with HCC received radiofrequency ablation. The therapeutic effect was analyzed one month after operation. The evaluation value of serum FER, AFP and AFP-L3 was analyzed. 【Results】The serum FER, AFP and AFP-L3 levels in HCC group were significantly higher than those in the benign liver disease group ( P <0.05).The sensitivity of FER, AFP and AFP-L3 alone in the diagnosis of HCC was 72.50%, 77.50% and 81.25% respectively. The specificity was 78.75%, 87.50% and 86.25%, respectively. The accuracy rates were 75.63%, 82.50% and 83.75%, respectively. The consistency of Kappa test with pathological diagnosis was 0.513, 0.650 and 0.675.The sensitivity, specificity, accuracy and consistency of FER, AFP and AFP-L3 in the diagnosis of hepatocellular carcinoma were 90.00%, 92.50%, 91.25% and 0.825.The sensitivity, specificity and accuracy of FER and AFP combined with AFP-L3 in the diagnosis of HCC were 90.00%, 92.50% and 91.25%, respectively. Its consistency with pathological diagnosis was 0.825. Among 80 cases of liver cancer patients, 65 cases were effective after treatment, and the overall response rate was 81.25%. The serum levels of FER, AFP and AFP-L3 in the effective treatment group were significantly lower than those in the ineffective treatment group ( P <0.05).The area under the curve of FER, AFP and AFP-L3 alone for evaluating the curative effect of HCC alone was 0.671, 0.688 and 0.716. The area under the curve of FER, AFP and AFP-L3 combined evaluation was 0.797. 【Conclusion】Serum level of FER, AFP and AFP-L3 alone has certain value in the diagnosis and evaluation of curative effect of HCC and the combined evaluation has the best effect.
单永锋, 郁皓, 刘慧, 王昊楠, 张彬彬, 曹斐, 吴晓霞. 铁蛋白、甲胎蛋白和甲胎蛋白异质体检测对肝癌诊断及疗效评估的价值[J]. 医学临床研究, 2021, 38(3): 396-398.
SHAN Yong-feng, YU Hao, LIU Hui, et al. Application of Single and Combined Detection of FER, AFP and AFP-L3 in Diagnosis and Therapeutic Evaluation of Hepatocellular Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2021, 38(3): 396-398.
2021, Vol. 38 
