γ-谷氨酰转肽酶和甲胎蛋白表达的相关性及其在肝细胞癌诊断中的价值

高春; 房龙; 姚树坤

doi:10.3969/j.issn.1001-5256.2014.09.021

γ-谷氨酰转肽酶和甲胎蛋白表达的相关性及其在肝细胞癌诊断中的价值

DOI: 10.3969/j.issn.1001-5256.2014.09.021

卫生部中日友好医院消化内科

基金项目:

北京市科技新星计划资助项目(Z131107000413067)；卫生部中日友好医院青年课题(2013-QN-07、2013-QN-06)；

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中图分类号: R735.7
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出版历程
- 收稿日期: 2013-09-25
- 出版日期: 2014-09-20

Correlation of GGT with AFP and diagnostic value of GGT for hepatocellular carcinoma

Department of Gastroenterology, China - Japan Friendship Hospital, Ministry of Health

Research funding:

摘要

摘要:
目的旨在分析γ-谷氨酰转肽酶（GGT）和甲胎蛋白（AFP）表达的相关性,同时从二者相关性的角度再次评价GGT在肝细胞癌（HCC）诊断中的准确性及价值。方法研究纳入2003年1月到2009年6月在卫生部中日友好医院住院治疗的HCC和肝硬化患者472例,分析GGT和AFP的相关性,诊断界值的确定主要依据受试者工作特征（ROC）曲线、曲线下面积（AUC）、敏感性和特异性,诊断价值以敏感性、特异性和正确指数来表示。统计学分析采用SPSS 17.0软件包。对于符合正态分布的计量资料,采用独立样本的t检验;对于偏态分布的计量资料,采用独立样本的非参数检验（Mann-Whitney U-test）;对于计数资料,根据不同的条件分别采用Pearson卡方检验、连续校正卡方检验和Fisher精确检验。结果 472例患者中,包括HCC患者224例,肝硬化患者248例。GGT水平在2组患者中分别为113（58254）U/L和38（2272）U/L;AFP表达在2组中分别为429.5（15.71210.0）ng/ml和5.7（3.41...
- 癌,肝细胞 /
- γ-谷氨酰转移酶 /
- 甲胎蛋白类 /
- 诊断
Abstract:
Objective To analyze the correlation of gamma- glutamyl transpeptidase ( GGT) level with alpha- fetoprotein ( AFP) level and to re- evaluate the diagnostic value of GGT for hepatocellular carcinoma ( HCC) . Methods Four hundred and seventy- two patients with HCC or liver cirrhosis, who were hospitalized in China- Japan Friendship Hospital from January 2003 to June 2009, were included in the study. The correlation between GGT and AFP was analyzed by Spearman nonparametric test. The cut- off values for the two parameters were determined based on their receiver operating characteristics ( ROC) curves, areas under the ROC curve ( AUCs) , sensitivity, and specificity, and the diagnostic values were presented using their sensitivity, specificity, and correct index. Statistical analysis was performed using SPSS 17. 0. Normally distributed continuous data were analyzed by independent- samples t test, while non- normally distributed continuous data were analyzed by Mann- Whitney U test. Categorical data were analyzed by Pearson chi- square test, continuity- corrected chi-square test, or Fisher's exact test. Results Among 472 patients, 224 were diagnosed with HCC, and 248 with liver cirrhosis. Compared with cirrhotic patients, HCC patients had a significantly higher GGT level ( 113 ( 58- 254) U /L vs 38 ( 22- 72) U /L, Z =- 11. 037, P <0. 001) and a significantly higher AFP level ( 429. 5 ( 15. 7- 1210. 0) ng /ml vs 5. 7 ( 3. 4- 18. 2) ng /ml, Z =- 10. 157, P < 0. 001) . A significant correlation was found between GGT and AFP ( r = 0. 449, P < 0. 001) . The AUC was 0. 784 for GGT and 0. 788 for AFP. The cut- off value was 60 U /L for GGT and 20 ng /ml for AFP. The sensitivity was 74. 1% for GGT, 71. 8% for AFP, and 90. 7% for a combination of the two parameters, the specificity was 70. 2%, 77. 6%, and 58. 7%, respectively, and the correct index was 0. 443, 0. 494, and0. 494, respectively. Conclusion GGT may be regarded as one biomarker for HCC, and its level is significantly correlated with AFP level.The diagnostic value of AFP may not be improved when used in combination with GGT.
- carcinoma, hepatocellular /
- gamma-glutamyltransferase /
- alpha-fetoproteins /
- diagnosis

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