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目的讨论肝细胞癌(hepatocellular carcinoma,HCC)的临床早期诊断中脱-γ-羧基凝血酶原(des-γ-carboxy prothrombin,DCP)检测的应用价值。方法选取2014年1月—2015年3月收治的HCC患者42例作为HCC组;选择同期住院的其他肿瘤患者38例作为其他肿瘤组;选择同期住院的肝脏疾病(非HCC)患者40例作为肝病组;另选健康体检者36例作为对照组。测定并比较各组DCP及AFP含量。计量资料比较采用方差分析,两两比较采用LSD-t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 HCC组、其他肿瘤组、肝病组、对照组AFP及DCP浓度分别为(793.12±682.28)、(653.28±457.26)、(9.68±8.24)、(11.14±6.58)、(8.82±7.82)、(9.12±5.83)、(4.15±3.01)、(3.82±2.03)ng/ml,HCC组显著高于其他三组,差异均有统计学意义(均P<0.05)。其他肿瘤组及肝病组显著高于对照组,差异均有统计学意义(均P<0.05)。HCC定界值为AFP>20ng/ml时,特异性、灵敏度分别为71.43%、83.26%;HCC定界值为DCP>12 ng/ml时,灵敏度、特异性分别为81.18%、73.82%,二者联合时分别为87.68%、81.01%;均高于二者单独使用。HCC病灶大小与DCP浓度存在正相关关联(r=0.664)。结论 DCP可有效对HCC进行诊断,联合AFP效果更佳。
Objective To discuss the value of detecting des-γ-carboxy prothrombin (DCP) in the early clinical diagnosis of hepatocellular carcinoma (HCC). Methods Forty-two patients with HCC admitted to our hospital from January 2014 to March 2015 were enrolled as HCC patients. Thirty-eight patients with other tumors were enrolled in this study. Forty patients with concurrent liver disease (non-HCC) 36 healthy subjects were selected as control group. The levels of DCP and AFP in each group were determined and compared. Measurement data were compared using analysis of variance, pairwise comparison using LSD-t test, counting data using χ2 test, P <0.05 for the difference was statistically significant. Results The concentrations of AFP and DCP in HCC group, other tumor group, liver disease group and control group were (793.12 ± 682.28), (653.28 ± 457.26), (9.68 ± 8.24), (11.14 ± 6.58), (8.82 ± 7.82) 9.12 ± 5.83), (4.15 ± 3.01) and (3.82 ± 2.03) ng / ml, respectively, which were significantly higher in HCC group than in the other three groups (all P <0.05). Other tumor and liver disease group was significantly higher than the control group, the difference was statistically significant (P <0.05). The specificity and sensitivity were 71.43% and 83.26% for the HCC cutoff value of AFP> 20ng / ml and 81.18% and 73.82% for the HCC cutoff value of DCP> 12ng / ml, respectively When combined, were 87.68% and 81.01% respectively, both higher than the two alone. There was a positive correlation between the size of HCC and the concentration of DCP (r = 0.664). Conclusions DCP can effectively diagnose HCC, combined with AFP better.