甲胎蛋白异质体3等三项肿瘤指标物对不同甲胎蛋白状态下原发性肝癌的诊断价值

Diagnostic Value of Three Tumor Biomarkers, Including Alpha Fetoprotein Variants 3, for Primary Liver Cancer in Various Alpha-Fetoprotein Conditions

摘要: 目的：探讨甲胎蛋白异质体3 (Alpha fetoprotein Variants 3)等三项肿瘤指标物对不同甲胎蛋白(alpha fetoprotein, AFP)状态下原发性肝癌(primary liver cancer, PLC)的诊断价值。方法：回顾性选取我院门诊和住院的182例乙型肝炎病毒(hepatitis B virus, HBV)感染者为研究对象，将肝癌组分为AFP阳性亚组及AFP阴性亚组，采用受试者工作特征(receiver operating characteristic, ROC)曲线评价不同肿瘤标志物对PLC的诊断效能。结果：血清ALT、AST、ALP、ALB、PLT、PT和INR水平在肝癌组、慢乙肝组以及肝硬化组三组之间有统计学差异(P < 0.05)，血清GGT、TBIL、DBIL、IBIL和GLB水平在三组间统计学上无显著差异(P > 0.05)。AFP阳性亚组的血清AFP、AFP-L3和AFP-L3%水平均较高，且差异具有统计学意义(P < 0.05)，GP73水平高于阴性组(P > 0.05)。无论是AFP阳性亚组还是AFP阴性亚组与非肝癌组相比较时，GP73的水平差别并不显著(P > 0.05)。AFP阳性亚组中，除了AFP外，AFP-L3表现出最高的灵敏度(97.30%)和特异度(84.50%)，而在AFP阴性亚组中，AFP-L3%表现出最高的特异度。结论：血清AFP-L3、AFP-L3%水平在AFP阳性亚组时对原发性肝癌的诊断价值较高，血清GP73水平对PLC诊断的价值较低。

Abstract: Objective: Exploring the diagnostic value of three tumor indicators, including alpha fetoprotein Variants 3, for primary liver cancer (PLC) under different alpha fetoprotein (AFP) states. Method: A retrospective study was conducted on 182 patients with hepatitis B virus (HBV) infection in our hospital’s outpatient and inpatient departments. The liver cancer group was divided into AFP positive and AFP negative subgroups, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of different tumor markers for PLC. Results: Serum ALT, AST, ALP, ALB, PLT, PT and INR levels were significantly different among the three groups (P < 0.05) There was no significant difference in serum GGT, TBIL, DBIL, IBIL, and GLB levels among the three groups (P > 0.05). The serum levels of AFP, AFP-L3, and AFP-L3% were higher in the AFP positive subgroup, and the differences were statistically significant (P < 0.05). The GP73 level was higher in the AFP positive subgroup than in the negative subgroup (P > 0.05). The difference in GP73 levels between the AFP positive and AFP negative subgroups and the non liver cancer group was not significant (P > 0.05). In the AFP positive subgroup, besides AFP, AFP-L3 showed the highest sensitivity (97.30%) and specificity (84.50%), while in the AFP negative subgroup, AFP-L3% showed the highest specificity. Conclusion: The diagnostic value of serum AFP-L3 and AFP-L3% levels for primary liver cancer is higher in the AFP positive subgroup, while the diagnostic value of serum GP73 level for PLC is lower.