纤维蛋白原/前白蛋白比值、γ-谷氨酰转肽酶/血小板比值在甲胎蛋白阴性肝细胞癌中的应用价值

摘要/Abstract

摘要： 目的评估纤维蛋白原/前白蛋白比值(FPR)、γ-谷氨酰转肽酶/血小板比值(GPR)在甲胎蛋白阴性肝细胞癌(AFP-N HCC)患者中的应用价值。方法 2018年3月至2020年3月AFP-N HCC患者(AFP-N HCC组)80例(男58例、女22例),年龄(50.2±9.8)岁。另选取同期健康体检患者(健康组)100例(男60例、女40例),平均年龄(49.8±6.2)岁。Logistic回归分析确定影响AFP-N HCC独立预测因素;ROC曲线确定诊断AFP-N HCC的截断点,计算诊断效能。结果 AFP-N HCC组、健康组PLT、Hb、FIB、PA、ALT、AST、TBil、γ-GT、FPR及GPR具有显著性差异(P<0.05)。以患者是否存在AFP-N HCC为分类标准,将PLT、Hb、FIB、PA、ALT、AST、TBil、γ-GT、FPR及GPR纳入多因素Logistic回归分析。结果显示,ALT、FPR、GPR是评估是否存在AFP-N HCC的独立影响因素(P<0.05)。FPR诊断AFP-N HCC时AUC及95%CI、截断点、敏感度及特异度分别为0.94(0.90～0.96)、11.60、86.5%及88.4%;GPR诊断AFP-N HCC时AUC及95%CI、截断点、敏感度及特异度分别为0.89(0.85～0.92)、0.21、68.4%及94.8%;FPR联合GPR诊断AFP-N HCC时AUC及95%CI、敏感度及特异度分别为0.97(0.95～0.99)、91.0%及96.2%。结论 FPR、GPR可作为AFP-N HCC诊断的生物学指标,两者联合诊断时效能优异。

关键词: 甲胎蛋白阴性肝细胞癌, 纤维蛋白原/前白蛋白比值, γ-谷氨酰转肽酶/血小板比值

Abstract: Objective To evaluate the value of fibrinogen/prealbumin ratio (FPR) and γ-glutamyl transpeptidase/platelet ratio (GPR) in alpha-fetoprotein-negative hepatocellular carcinoma (AFP-N HCC). Methods From March 2018 to March 2020, there were 80 AFP-N HCC patients (58 males and 22 females) with an average age of (50.2 ± 9.8) years, and 100 patients undergoing physical examination (60 males and 40 females) with an average age of (49.8 ± 6.2) years enrolled in the study. The independent predictive factors of AFP-N HCC were analyzed by Logistic regression. Cut-off points for diagnosing AFP-N HCC were determined by receiver operating characteristic (ROC) curve, and the diagnostic efficiency was calculated. Results There were significant differences in platelet, hemoglobin, fibrinogen, phosphatidic acid, alanine transaminase (ALT), aspartate transaminase, total bilirubin, gamma-glutamyl transpeptidase, FPR and GPR between AFP-N HCC group and healthy group (P<0.05). Logistic regression analysis showed that ALT, FPR and GPR were independent factors for AFP-N HCC (P<0.05). The cut-off value of FPR for diagnosing AFP-N HCC was 11.60, with area under the curve (AUC) [95% confidence interval (CI)] of 0.94 (0.90-0.96), sensitivity of 86.5%, and specificity of 88.4%. The cut-off value of GPR for diagnosing AFP-N HCC was 0.21, with AUC (95% CI) of 0.89 (0.85-0.92), sensitivity of 68.4% and specificity of 94.8%. Combining FPR and GPR, the AUC (95% CI), sensitivity and specificity were 0.97 (0.95-0.99), 91.0% and 96.2%, respectively. Conclusion FPR and GPR can be used for the diagnosis of AFP-N HCC. The combination of FPR and GPR has better diagnostic value.

Key words: Alpha-fetoprotein-negative hepatocellular carcinoma, Ratio of fibrinogen to prealbumin, Ratio of gamma-glutamyl transpeptidase to platelet

王蔚, 李慧艳, 刘华. 纤维蛋白原/前白蛋白比值、γ-谷氨酰转肽酶/血小板比值在甲胎蛋白阴性肝细胞癌中的应用价值[J]. 肝脏, 2021, 26(3): 270-272.

WANG Wei, LI Hui-yan, LIU Hua. Diagnostic value of fibrinogen/prealbumin ratio and γ-glutamyl transpeptidase/platelet ratio in alpha-fetoprotein-negative hepatocellular carcinoma[J]. Chinese Hepatolgy, 2021, 26(3): 270-272.

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