| 血清PIVKA-Ⅱ测定在41例HCC诊断中的应用及其特异性分析 |
| 投稿时间：2016-12-10 修订日期：2016-12-26 点此下载全文 |
| 引用本文：宋正霞,丁芹,秦亚楠,洪雷,张言超,颜学兵.血清PIVKA-Ⅱ测定在41例HCC诊断中的应用及其特异性分析[J].医学研究杂志,2017,46(8):19-21,59 |
| DOI：
10.11969/j.issn.1673-548X.2017.08.006 |
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| 基金项目:国家自然科学基金资助项目（面上项目）（81371867）；江苏省高校自然科学基础研究基金资助项目（08KJD320012） |
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| 中文摘要:目的 分析人异常凝血酶原即维生素K缺乏或拮抗剂Ⅱ诱导蛋白（protein induced by vitamin K absence or antagonist-Ⅱ，PIVKA-Ⅱ）在慢性乙型肝炎、肝细胞癌及梗阻性黄疸患者血清中的表达特点，评价其在肝细胞癌的诊断价值。方法 检测徐州医科大学附属医院131例患者血清PIVKA-Ⅱ、甲胎蛋白（AFP）浓度，包括慢性乙型肝炎74例，梗阻性黄疸16例，肝细胞癌41例。结果 肝细胞癌组患者血清PIVKA-Ⅱ水平高于慢性乙型肝炎组、梗阻性黄疸组（P均<0.05）。PIVKA-Ⅱ诊断肝细胞癌的敏感度和特异性分别为73.17%、85.14%，AFP分别为68.29%、51.35%；平行诊断实验的敏感度为85.37%。在肝细胞癌患者中，肿瘤直径>5cm患者的PIVKA-Ⅱ水平明显高于直径≤5.0cm患者，差异有统计学意义（P<0.05）；T3、T4期患者PIVKA-Ⅱ的水平明显高于T1、T2期患者，差异有统计学意义（P<0.05）。结论 梗阻性黄疸患者血清PIVKA-Ⅱ无明显升高。肝炎活动会引起PIVKA-Ⅱ水平变化，但是低于正常上限。血清PIVKA-Ⅱ在诊断肝细胞癌的敏感度和特异性均高于AFP，联合诊断可提高敏感度。外周血PIVKA-Ⅱ水平与肿瘤直径、TNM分期有关。 |
| 中文关键词:PIVKA-Ⅱ 梗阻性黄疸 肝细胞癌 乙型肝炎 |
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| Application of Serum PIVKA-Ⅱ in the Diagnosis of 41 Patients with HCC and the Analysis of Its Pecificity |
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| Abstract:Objective To analyze the characteristic expression of serum protein induced by vitamin K absence or antagonist-Ⅱ expressed in patients with chronic hepatitis B or cirrhosis, obstructive joundice and hepatocellular carcinoma and estimated its diagnostic value in hepatocellular carcinoma. Methods Patients with chronic hepatitis B (n=74), obstructive joundice (n=16) and HCC(n=41) were from the Affiliated Hospital of Xuzhou Medical University, whose serum level of PIVKA-Ⅱ and AFP was detected. Results The serum level of PIVKA-Ⅱ in HCC group were higher than that in chronic hepatitis B and obstructive joundice groups(P<0.05).The sensitivity and pecificity of PIVKA-Ⅱ were respectively 73.17% and 85.14%, AFP respectively 68.29% and 51.35%. The sensitivity of parallel diagnosis was 85.37%. Serum level of PIVKA-Ⅱ in HCC patients which tumor diameter less than 5cm was higher than that tumor diameter no more than 5cm(P<0.05). Serum level in HCC patients from Ⅲ-Ⅳ stages was higher than that from Ⅰ-Ⅱ stages(P<0.05). Conclusion The serum level of PIVKA-Ⅱ in patienrs with obstructive joundice was low. Activation of hepatitis could result in the change of serum PIVKA-Ⅱ level, but below the upper limit of normal. The sensitivity and pecificity of PIVKA-Ⅱ in diagnosing HCC were both higher than AFP, and the combined detection of PIVKA-Ⅱ and AFP could increase the sensitivity. The serum levels of PIVKA-Ⅱ were related to tumor size and tumor stages. |
| keywords:PIVKA-Ⅱ Obstructive joundice Hepatocellular carcinoma Chronic hepatitis B |
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