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摘要：
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摘要：目的 探讨异常凝血酶原（protein induced by vitamin K absence or antagonist-Ⅱ，PIVKA-Ⅱ）
联合甲胎蛋白（α-fetoprotein，AFP）检测在HBV相关肝细胞癌（hepatocellular carcinoma，HCC）中
的诊断价值，方法 选取2017年2月至2018年1月于湖北医药学院附属人民医院治疗的HBV相关HCC患
者258例为研究对象，检测患者血清AFP和PIVKA-Ⅱ水平，分析不同肝癌分期、HBV基因型、HBV
DNA载量及HBV感染时长患者AFP和PIVKA-Ⅱ水平的差异，计算AFP和PIVKA-Ⅱ检测HBV相关HCC
患者的阳性率、敏感性和特异性。结果 不同HBV基因型和不同HBV感染时长的HCC患者血清AFP和
PIVKA-Ⅱ水平差异无统计学意义（P ＞ 0.05），不同HBV DNA载量和肝癌分期HCC患者血清AFP和
PIVKA-Ⅱ水平差异有统计学意义（P ＜ 0.05）。PIVKA-Ⅱ联合AFP检测的阳性预测值、敏感度和特
异性分别为91.01%、84.57%和88.24%，均显著高于PIVKA-Ⅱ和AFP单独检测（P ＜ 0.05）。结论 血
清PIVKA-Ⅱ与AFP联合检测可作为临床筛查HBV相关HCC患者的重要指标，HBV DNA载量、临床肝
癌分期结合血清AFP和PIVKA-Ⅱ水平有助于HCC的早发现、早诊断、早治疗。
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Abstract: Objective To investigate the diagnostic value of detection of protein induced by vitamin K
absence (PIVKA-Ⅱ) combined with alpha-fetoprotein (AFP) in patients with HBV associated hepatocellular
carcinoma (HCC). Methods Total of 258 cases with HBV associated HCC in Renmin Hospital, Hubei
University of Medicine from February 2017 to January 2018 were selected. The serum levels of AFP and
PIVKA-Ⅱwere detected. The levels of AFP and PIVKA-Ⅱ in patients with different stages of liver cancer,
different HBV DNA loads, different HBV genotypes and different periods of HBV infection were analyzed.
The positive rate, sensitivity and specificity of AFP combined with PIVKA-Ⅱ detection in patients with HBV
associated HCC were calculated. Results There were no significant differences in serum AFP and PIVKA-Ⅱ
levels between patients with different HBV genotypes and HBV infection periods (P ＞ 0.05), and there were
significant differences in serum AFP and PIVKA-Ⅱ levels between patients with different HBV DNA loads
and liver cancer stages (P ＜ 0.05). The positive predictive value, sensitivity and specificity of PIVKA-Ⅱ
combined with AFP were 91.01% , 84.57% and 88.24%, respectively, which were significantly higher than
those of PIVKA-Ⅱ and AFP alone (P ＜ 0.05). Conclusions The combined detection of serum PIVKA-Ⅱ
and AFP can be used as important indexes for clinical screening of patients with HBV associated HCC. HBV
DNA loads, clinical liver cancer stages combined with serum AFP and PIVKA-Ⅱ levels are helpful for early
detection, early diagnosis and early treatment of HCC.
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