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目的探讨血清胸苷激酶1(thymidine kinase 1,TK1)在乙型肝炎病毒(Hepatitis B virus,HBV)感染不同临床类型患者血清中表达的差异,以及TK1在原发性肝癌早期诊断中的临床价值。方法利用免疫增强化学发光法检测安徽医科大学第一附属医院2014年8月至2015年3月收治的120例慢性HBV感染患者的血清TK1水平,其中慢性乙型肝炎组(CHB组)、乙型肝炎肝硬化组(LC组)及原发性肝癌组(HCC组)各40例,并选取40名健康体检者(NC组)进行对照,同时检测各组甲胎蛋白(AFP)水平。并绘制出TK1、AFP以及联合诊断模型的受试者工作特征曲线(ROC曲线)。结果 (1)三组患者血清TK1水平均高于NC组,且TK1在各组人群的表达水平为:HCC组>LC组>CHB组(P<0.05);(2)通过ROC曲线分析得出TK1、AFP及TK1联合AFP诊断早期HCC的敏感度依次为81.3%,65.2%,85.1%,特异度依次为71.4%,82.2%,72.5%,ROC曲线下面积(AUROC值)和95%可信区间(95%CI)分别为0.768(0.665~0.872),0.767(0.660~0.873),0.847(0.765~0.930)。结论 (1)TK1有助于监测CHB、LC及HCC的疾病进程;(2)TK1与AFP联合诊断HCC的灵敏度提高,可与AFP联合诊断HCC,以便发现早期HCC。
Objective To investigate the difference of the expression of serum thymidine kinase 1 (TK1) in the serum of patients with different clinical types of hepatitis B virus (HBV) infection and the clinical value of TK1 in the early diagnosis of primary liver cancer . Methods The levels of serum TK1 in 120 patients with chronic HBV infection admitted to the First Affiliated Hospital of Anhui Medical University from August 2014 to March 2015 were detected by immuno-enhanced chemiluminescence (CLB) method. Among them, chronic hepatitis B (CHB), type B Forty patients with liver cirrhosis (LC group) and primary hepatocellular carcinoma (HCC) were enrolled in this study. Forty healthy subjects (NC group) were selected as control group. AFP levels in each group were also measured. And plotted the receiver operating characteristic curve (ROC curve) of TK1, AFP and the combined diagnostic model. Results (1) The level of serum TK1 in three groups was higher than that in NC group, and the expression level of TK1 in each group was: HCC group> LC group> CHB group (P <0.05); (2) By ROC curve analysis The sensitivity of TK1, AFP and TK1 combined with AFP in the diagnosis of early stage HCC were 81.3%, 65.2% and 85.1% respectively, and the specificity was 71.4%, 82.2% and 72.5% respectively. The area under the ROC curve (AUROC) and 95% confidence The intervals (95% CI) were 0.768 (0.665-0.872), 0.767 (0.660-0.873) and 0.847 (0.765-0.930), respectively. Conclusions (1) TK1 is helpful to monitor the course of disease of CHB, LC and HCC. (2) The sensitivity of TK1 and AFP combined diagnosis of HCC can be improved with AFP combined diagnosis of HCC in order to find early HCC.