首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2018年 11期 肝脏病理 => 肝脏肿瘤 =>甲胎蛋白诊断和筛查原发性肝癌的阈..
甲胎蛋白诊断和筛查原发性肝癌的阈值分析
A threshold analysis of alpha-fetoprotein in diagnosis and screening of hepatocellular carcinoma
文章发布日期:2018年09月30日  来源:  作者:田州,张建淮  点击次数:321次  下载次数:67次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的探讨AFP在原发性肝癌(HCC)诊断和早期筛查中的最佳阈值。方法收集2007年-2017年于南京医科大学附属淮安第一医院住院、门诊和健康体检确诊的2212例HCC和1998例非HCC患者的临床资料,统计AFP水平。将AFP水平划分为10~20 μg/L、21~65 μg/L、66~110 μg/L、111~155 μg/L、156~200μg/L、201~250 μg/L、251~300 μg/L、301~350 μg/L、351~400 μg/L、>400 μg/L 10个阈值。比较各阈值、B超以及二者联合诊断HCC的联合敏感度、特异度、阳性似然比、阴性似然比、诊断优势比。构建受试者工作特征曲线(ROC曲线)测定最佳诊断阈值。结果AFP阈值201~250 μg/L组的灵敏度与特异度之和最大(1370 1),ROC曲线下面积最大(0.896 4)。AFP>20 μg/L联合B超诊断肝癌的敏感度最高(95.35%),诊断优势比为26.13。结论临床诊断HCC的AFP最佳阈值为200 μg/L。应用AFP检测联合B超检查对HCC高危人群进行筛查时,可以将AFP>20 μg/L作为阳性指标,结合进一步的鉴别诊断、密切随访和跟踪检查,减少筛查漏诊率。
【Abstract】:ObjectiveTo investigate the optimal cut-off value of alpha-fetoprotein (AFP) in the diagnosis and early screening of hepatocellular carcinoma (HCC). MethodsThe clinical data of 2212 HCC patients who were diagnosed and hospitalized in our hospital and 1998 non-HCC patients were collected, and the AFP level was summarized. The AFP level was divided into 10 ranges of 10-20 μg/L, 21-65 μg/L, 66-110 μg/L, 111-155 μg/L, 156-200 μg/L, 201-250 μg/L, 251-300 μg/L, 301-350 μg/L, 351-400 μg/L, and >400 μg/L, and a comparative analysis was performed for the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of each cut-off value of AFP, ultrasound, and their combination in the diagnosis of HCC. The receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value. ResultsThe cut-off valve of AFP of 200-250 μg/L had the largest sum of sensitivity and specificity (1.370 1) and the largest area under the ROC curve (0.896 4). AFP >20 μg/L combined with ultrasound had the highest sensitivity (95.35%) in the diagnosis of HCC, with a diagnostic odds ratio of 26.13. ConclusionThe optimal cut-off value of AFP in the diagnosis of HCC is 200 μg/L. When AFP combined with ultrasound is used for the screening of people at a high risk of HCC, AFP>20 μg/L is recommended as a positive index, and its combination with differential diagnosis and close follow-up and examinations can reduce the false negative rate of screening.
【关键字】:甲胎蛋白类; 肝肿瘤; 参考值; 诊断; 普查
【Key words】:alpha-fetoproteins; liver neoplasms; reference values; diagnosis; mass screening
【引证本文】:TIAN Z, ZHANG JH. A threshold analysis of alpha-fetoprotein in diagnosis and screening of hepatocellular carcinoma[J]. J Clin Hepatol, 2018, 34(11): 2352-2355. (in Chinese) 田州, 张建淮. 甲胎蛋白诊断和筛查原发性肝癌的阈值分析[J]. 临床肝胆病杂志, 2018, 34(11): 2352-2355.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号