中国肝脏病杂志(电子版)

位置：首页 >> 期刊文章

异常凝血酶原对原发性肝癌的诊断价值

作者：胡明芬 1 庄林 1 李云丽 1 柏保利 1 杨红洁 1 彭静 2 李冬玲 3 禹蔚琴 1 王晴晴 1 匡小林 1

单位：1.昆明市第三人民医院肝一科昆明 650000 2.昆明市第三人民医院人工肝室昆明 650000 3.昆明市第三人民医院检验科昆明 650000

关键词：异常凝血酶原原发性肝癌甲胎蛋白诊断

分类号：

出版年,卷(期):页码：2017,9(1):79-82

摘要：

摘要：目的探讨异常凝血酶原（PIVKA-Ⅱ）对原发性肝癌（PLC）的诊断价值。方法收集2015年
12月至2016年5月于本院住院的436例肝病患者，其中原发性肝癌患者108例，慢性乙型肝炎（CHB）
患者108例，慢性丙型肝炎（CHC）患者111例，肝硬化患者109例。采用电化学发光法检测所有患
者血清PIVKA-Ⅱ和甲胎蛋白（AFP）水平。比较PIVKA-Ⅱ、AFP单独及联合检测诊断原发性肝癌
的敏感度、特异度和曲线下面积。结果原发性肝癌组、慢性乙型肝炎组、慢性丙型肝炎组和肝硬化
组患者血清PIVKA-Ⅱ水平（mAu/ml）分别为1708.5（14，75000）、24（10，916）、26（4，83）
和22（1.13，5474），原发性肝癌组患者PIVKA-Ⅱ的中位值显著高于慢性乙型肝炎组、慢性丙型肝
炎组和肝硬化组，差异有统计学意义（Z值分别为-10.899、-10.414、-11.415，P均＜ 0.001）。原发
性肝癌组、慢性乙型肝炎组、慢性丙型肝炎组和肝硬化组患者血清AFP水平（ng/ml）分别为436.3
（0.79，7121000）、3.49（0.61，1614）、4.12（1.08，73.26）和4.57（0.73，9422），原发性肝癌
组患者AFP的中位值显著高于慢性乙型肝炎组、慢性丙型肝炎组和肝硬化组，差异有统计学意义（Z
值分别为-8.937、-9.124、-9.001，P均＜ 0.001）。PIVKA-Ⅱ、AFP及PIVKA-Ⅱ联合AFP的敏感度分
别为90.40%、94.15%、92.51%，差异无统计学意义（χ 2 = 4.105，P = 0.318）；PIVKA-Ⅱ、AFP及
PIVKA-Ⅱ联合AFP的特异度分别为82.41%、61.11%、81.48%，其中PIVKA-Ⅱ及PIVKA-Ⅱ联合AFP
与AFP单独检测的特异度差异有统计学意义（χ 2 = 3.167，P = 0.014），而PIVKA-Ⅱ与PIVKA-Ⅱ联合
AFP检测的特异度间差异无统计学意义（χ 2 = 4.973，P = 0.403）。结论血清PIVKA-Ⅱ诊断原发性肝
癌的价值高于AFP，PIVKA-Ⅱ与AFP联合PIVKA-Ⅱ的诊断价值无差异。

Abstract: Objective To investigate the diagnostic value of PIVKA-Ⅱ on primary liver cancer (PLC).
Methods A total of 436 patients with liver diseases were enrolled in our hospital from December 2015 to
May 2016, including 108 cases with PLC, 108 cases with chronic hepatitis B (CHB), 111 cases with chronic
hepatitis C (CHC), and 109 cases with liver cirrhosis. The serum PIVKA-Ⅱ and alpha-fetoprotein (AFP)
levels were measured by electrochemiluminescence in all patients. The sensitivity, specificity and AUS of
PIVKA-Ⅱ, AFP and PIVKA-Ⅱcombined with AFP in diagnosing primary liver cancer were analyzed.
Results The serum levels of PIVKA-Ⅱ(mAu/ml) in PLC group, CHB group, CHC group and liver cirrhosis
group were 1708.5 (14, 75000), 24 (10, 916), 26 (4, 83) and 22 (1.13), respectively. The median value of
PIVKA-Ⅱ in PLC group was significantly higher than those in CHB group, CHC group and liver cirrhosis
group (Z = -10.899, -10.414, -11.415, P ＜ 0.001). The serum levels of AFP (ng/ml) in PLC group, CHB
group, CHC group and liver cirrhosis group were 436.3 (0.79, 7121000), 3.49 (0.61, 1614), 4.12 (1.08,
73.26) and 4.57 (0.73, 9422), respectively. The median value of AFP in PLC group was significantly higher

than those in CHB group, CHC group and liver cirrhosis group (Z = -8.937, -9.124, -9.001, P ＜ 0.001). The
sensitivity of PIVKA-Ⅱ, AFP and AFP combined with PIVKA-Ⅱ in diagnosing PLC were 90.40%, 94.15%
and 92.51%, respectively, which had no significant difference (χ 2 = 4.105，P = 0.318). The specificity of
PIVKA-Ⅱ, AFP and AFP combined with PIVKA-Ⅱ in diagnosing PLC were 82.41%, 61.11% and 81.48%,
respectively. The specificity of PIVKA-Ⅱ and PIVKA-Ⅱ combined with AFP in the diagnosis of PLC were
significantly higher than that of AFP (χ 2 = 3.167, P = 0.014), which had no statistical difference between
PIVKA-Ⅱ and PIVKA-Ⅱ combined with AFP (χ 2 = 4.973, P = 0.403). Conclusion The diagnosing value of
serum PIVKA-Ⅱ in primary liver cancer is higher than that of AFP, but has no difference between PIVKA-Ⅱ
combined with AFP.

基金项目：

作者简介：

参考文献：

服务与反馈：

【文章下载】【加入收藏】