采用ROC曲线评价a-L-岩藻糖苷酶,5-核苷酸酶,甲胎蛋白在肝癌诊断、预后预测中的价值

摘要

目的：探讨 a-L-岩藻糖苷酶(AFU)、5-核苷酸酶(5’-NT)、甲胎蛋白(AFP)检测对原发性肝癌(PHC)的诊断价值。方法肝癌患者(肝癌组)40例,手术后6个月,根据肝癌是否复发,分为复发组和非复发组。另入选健康体检者(对照组)60例,测定3组 AFU、5’-NT、AFP 水平,应用受试者工作曲线(ROC)评估三者对肝癌的诊断和预测价值。结果 AFU、5’-NT 和 AFP 在肝癌组和对照组间比较差异均有统计学意义。AFU、5’-NT 和 AFP 3种指标单独检测时,ROC 曲线下面积分别为0.904,0.870,0.866。手术前以及手术后复发组 AFU 浓度均高于非复发组。手术前以及手术后复发组5’-NT 浓度与非复发组相比差异无统计学意义。手术后复发组 AFP 血清浓度高于非复发组,手术前复发组 AFP 血清浓度与非复发组相比差异无统计学意义。结论通过 ROC 曲线评价,检测 AFU 和5’-NT两种指标可用于对 PHC 的诊断,AFU 可以用于肝癌预后的预测。%Objective To explore the diagnosis value of α-L-fucosidase (AFU),5'-nucleo tidase (5 ’-NT)and alpha fetoprotein (AFP)detection in patients with primary hepatic carcinoma(PHC).Methods The study involved 40 patients with hepatocellular carcinoma as experimental group and 60 cases of physical examination as control group, using ROC curve to make a comparative analysis.The patients with hepatocellular carcinoma who experienced surgical treatment were followed up for average six months.The patients were divided into relapse group and non-recurrent group,to AFU,5-NT,AFP levels were detected to assess the predictive value.Results The level of AFU,5’-NT and AFP in PHC group were higher than those in control group (P <0.05).The area under the ROC curve for the three indexes were 0.904,0.870 and 0.866,respectively.The concentrations of AFU in preoperative and postoperative detection were significantly higher than those of non-recurrent group.However,5 - NT concentration showed no statistic difference between preoperative and postoperative concentration detection.Preoperative concentration of AFP was no significantly higher than that of non-recurrent group,but preoperation concentration of AFP was significantly higher than that of non recurrent group.Conclusion ROC curve suggests that the combined detection of AFU and 5'–NT is superior to any single index in PHC diagnosis.It can greatly increase the detection of PHC.AFU could be used as early recurrence indicator of PHC.