| 曹国强,邢春阳,孟雪芹.血清PIVKA-Ⅱ检测在原发性肝癌患者中的临床意义[J].肿瘤学杂志,2019,25(10):864-867. |
| 血清PIVKA-Ⅱ检测在原发性肝癌患者中的临床意义 |
| Clinical Significance of Serum PIVKA-Ⅱ in Patients with Primary Liver Cancer |
| 投稿时间：2018-12-05 |
| DOI：10.11735/j.issn.1671-170X.2019.10.B003 |
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| 中文关键词: 原发性肝癌 异常凝血酶原 脉管侵犯 |
| 英文关键词:primary liver cancer abnormal prothrombin vascular invasion |
| 基金项目:浙江省科技厅项目（2015C03034）；深圳市三名工程“深圳市肝胆疾病研究重点实验室项目”（ZDSYS201504301534057） |
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| 中文摘要: |
| 摘 要：［目的］研究血清异常凝血酶原PIVKA-Ⅱ在原发性肝癌中的表达水平及其临床意义。［方法］共纳入216例患者，包含105例肝细胞癌手术切除患者，54例肝内胆管细胞癌患者，57例乙肝肝硬化患者，同时入组96例健康体检者为对照。采用全自动化学发光免疫分析仪对血清标本进行PIVKA-Ⅱ及甲胎蛋白（AFP）浓度检测。基于受试者工作特征曲线（receiver operation characteristic curve，ROC）分析血清PIVKA-Ⅱ和AFP的检测结果，并确定PIVKA-Ⅱ检测肝细胞癌的最佳诊断界限值。比较肝癌患者手术前后PIVKA-Ⅱ水平的变化，分析术前肝细胞癌血清PIVKA-Ⅱ的表达水平与临床病理特征等各项指标的相关性。［结果］对于肝癌的诊断，血清PIVKA-Ⅱ的敏感度高于AFP（93.3% vs 56.2%）。肝细胞癌、肝内胆管细胞癌、乙肝肝硬化患者和健康体检者的血清PIVKA-Ⅱ水平分别为7928.51±15694.26 mAU/ml、49.06±168.54 mAU/ml、104.04±259.79 mAU/ml和21.54±5.80 mAU/ml。肝细胞癌手术切除后血清PIVKA-Ⅱ水平显著下降（P<0.001）。术前PIVKA-Ⅱ值与肿瘤大小、脉管侵犯以及TNM分期显著相关（P<0.05）。［结论］血清PIVKA-Ⅱ可用于肝细胞癌早期诊断及治疗监测，但其在肝内胆管细胞癌的诊断中敏感性较差。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate clinical significance of serum PIVKA-Ⅱ(protein induced by vitamin K absence or antagonist-Ⅱ) level in primary liver carcinoma(PLC). ［Methods］ Two hundred and sixteen patients with hepatobiliary diseases were enrolled in the study，including 105 cases of hepatocellular carcinoma(HCC)，54 cases of intrahepatic cholangiocarcinoma(ICC) and 57 cases of HBV-related cirrhosis；96 healthy subjects served as control group. The serum level of PIVKA-Ⅱ and alpha-fetoprotein(AFP) were detected by automatic chemiluminescence immunoassay. Based on receiver operation characteristic curve(ROC)，the detection results of serum PIVKA-Ⅱ and AFP were analyzed，and the optimal diagnostic threshold of PIVKA-Ⅱ for hepatocellular carcinoma was determined. The changes of PIVKA-Ⅱ levels in patients with hepatocellular carcinoma before and after operation were compared，and the correlation between serum PIVKA-Ⅱ expression level and clinicopathological characteristics of hepatocellular carcinoma before operation were analyzed. ［Results］ For the diagnosis of hepatocellular carcinoma，the sensitivity of serum PIVKA-Ⅱ was higher than that of AFP(93.3% vs 56.2%).The serum PIVKA-Ⅱ levels of HCC，ICC and HBV-related cirrhosis patients and healthy subjects were 7928.51±15694.26 mAU/ml，49.06±168.54 mAU/ml，104.04±259.79 mAU/ml and 21.54±5.80 mAU/ml，respectively. The serum PIVKA-Ⅱ level decreased significantly after hepatocellular carcinoma resection(P<0.001). Preoperative PIVKA-Ⅱ level was significantly correlated with tumor size，vascular invasion and TNM stage(all P<0.05). ［Conclusion］ Serum PIVKA-Ⅱ can be used for diagnosis and treatment monitoring of hepatocellular carcinoma，while it has poor sensitivity in the diagnosis of intrahepatic cholangiocarcinoma. |
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