联合血清AFP、TK1及DKK1水平检测对原发性肝癌诊断价值研究

摘要

目的 探讨血清甲胎蛋白(AFP)、胸苷激酶1(TK1)及分泌型蛋白Dickkopf-1(DKK1)联合检测对原发性肝癌(PHC)的诊断价值.方法 选取该院2015年8月到2016年10月收治的PHC患者85例作为PHC组;选择良性肝病患者73例作为良性肝病组;选取同期体检健康者80例作为对照组.分别检测三组研究对象的血清AFP、TK1、DKK1水平,同时比较各组的差异,计算出各指标诊断灵敏度、特异度、阳性预测值、阴性预测值及准确度.采用logistic回归分析各指标的诊断价值.结果 PHC组的血清AFP、TK1及DKK1水平均明显高于良性肝病组和对照组,差异有统计学意义(P<0.05);良性肝病组的血清AFP、TK1及DKK1水平均明显高于对照组,差异有统计学意义(P<0.05);AFP+ TK1+DKK1联合检测的灵敏度、准确度、阴性预测值均明显高于各指标单独检测,差异有统计学意义(P<0.05);Logistic回归分析显示,AFP、TK1及DKK1均与PHC诊断有着密切相关性(P<0.05).结论 联合血清AFP、TK1及DKK1检测可明显提高PHC阳性诊断率,以便其临床早期诊断和有效治疗,值得推广.%Objective To investigate the diagnostic value of combined detection of serum alpha fetoprotein (AFP),thymidine kinase 1(TK1)and secreted protein Dickkopf-1(DKK1)in patients with primary liver cancer(PHC).Methods 85 patients with PHC admitted to the hospital from August 2015 to October 2016 were selected as PHC group,and 73 patients with benign liver disease as benign liver disease group,and 80 ca-ses healthy subjects as the control group.The serum levels of AFP,TK1 and DKK1 were detected in three groups,and the differences in each group were compored,and the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calcuated.The diagnostic value of each index was analyzed by logistic regression.Results The serum AFP,TK1 and DKK1 levels in PHC group were signifi-cantly higher than those in benign liver disease group and control group(P<0.05),the serum AFP TK1 and DKK1 levles in benign liver disease group were significantly higher than those in the control group(P<0.05);the sensitivity,accuracy and negative predictive value of AFP + TK1+ DKK1 joint detection were sig-nificantly higher than that in the single index detection(P<0.05);Logistic regression analysis showed that AFP,TK1 and DKK1 were closely correlated with the diagnosis of PHC(P<0.05).Conclusion The com-bined detection of serum AFP,TK1 and DKK1 can significantly improve PHC positive diagnosis rate,which is of great significance for clinical early diagnosis and effective treatment,and is worth popularizing.