甲胎蛋白诊断和筛查原发性肝癌的阈值分析

田州; 张建淮

doi:10.3969/j.issn.1001-5256.2018.11.016

甲胎蛋白诊断和筛查原发性肝癌的阈值分析

DOI: 10.3969/j.issn.1001-5256.2018.11.016

田州,
张建淮

1. 南京医科大学
2. 新沂市中医院
3. 南京医科大学附属淮安第一医院肝胆外科

基金项目:

江苏省卫计委面上课题(H201668)；淮安市临床医学科技专项(HAS201411)；

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2018-11-20

A threshold analysis of alpha-fetoprotein in diagnosis and screening of hepatocellular carcinoma

Research funding:

摘要

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1020μg/L、2165μg/L、66110μg/L、111155μg/L、156200μg/L、201250μg/L、251300μg/L、301350μg/L、351400μg/L、> 400μg/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201250μg/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> 20μg/L联合B超诊断肝...
- 甲胎蛋白类 /
- 肝肿瘤 /
- 参考值 /
- 诊断 /
- 普查
Abstract:
Objective To investigate the optimal cut-off value of alpha-fetoprotein ( AFP) in the diagnosis and early screening of hepatocellular carcinoma ( HCC) . Methods The 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, 21-65μg/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. Results The 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. Conclusion The 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.
- alpha-fetoproteins /
- liver neoplasms /
- reference values /
- diagnosis /
- mass screening

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参考文献(14)

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