常用肝功能生化指标对原发性肝癌的诊断价值

白利青，宋娟

（陕西省榆林市星元医院检验科，陕西 榆林，719000）

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摘要：

目的 研究8项常用肝功能生化指标对原发性肝癌（PHC）的诊断价值。方法 选取216例我院收治的PHC患者作为肝癌组，另选200例无其他慢性疾病的健康体检者为对照组，两组均行常规肝功能检查，通过构建单因素和多因素Logistic 回归模型，并计算ROC曲线下面积（AUC）进行各指标的比较分析和联合诊断。结果 两组各项肝功能指标除TP外，其他指标比较差异均具有统计学意义（P<0.05）。单因素分析结果显示，两组年龄、性别及7项肝功能指标比较，差异有统计学意义（P<0.05）。通过ROC曲线分析，ALP 灵敏度较高，ALB及A/G 的特异度较高，DBIL 的AUC较高，ALB 及A/G的AUC<0.5。多因素Logistic 回归分析显示，两组年龄、DBIL 和ALA比较，差异有统计学意义（P<0.05），联合年龄、DBIL 和ALA 的多因素Logistic回归模型的灵敏度为75.03%，特异度为56.01%，AUC 为0.709。结论 相比于公认的肿瘤标志物甲胎蛋白（AFP），几项常用肝功能生化指标在 PHC敏感度、特异度方面的诊断无明显优势，但联合年龄、DBIL 和ALA 三因素可对PHC进行初步诊断，具一定参考价值。

关键词：原发性肝癌（PHC）；血清甲胎蛋白（AFP）；肝功能生化指标

中图分类号：R735.7 文献标志码：A文章编号：2096-1413(2017)26-0036-02

Diagnostic value of common biochemical indicators of liver function for primary hepatocellular cancer
BAI Li-qing, SONG Juan
(Department of Clinical Laboratory, Xingyuan Hospital in Yulin City, Yulin 719000, China)

ABSTRACT: Objective To discuss the diagnostic values of 8 common biochemical indicators in the diagnosis of primary hepatocellular cancer (PHC). Methods Two hundred and sixteen patients with PHC were selected as the PHC group, 200 cases of healthy people were chosen as the control group. All the objects received routine liver function tests, by building univariate and multivariate Logistic regression models and calculating the area under the ROC curve (AUC), each index was compared and joint diagnosis was made. Results Compared with the healthy control group, except for the TP, the biochemical indicators of liver function in the PHC group were significantly different (P<0.05). The univariate Logistic
regression analysis showed that the differences in age, sex and 7 indexes of liver function between the two groups were statistically significant (P<0.05). By ROC curve analysis, the sensitivity of ALP was higher, the specificity of A/G and ALB was higher, and the AUC of DBIL was higher, the AUC of ALB and A/G were less than 0.5. The multivariate Logistic regression analysis showed that the statistically significant variables were age, DBIL and ALA, with the sensitivity of 75.03% and specificity of 56.01%, AUC of 0.709. Conclusion Compared with tumor markers AFP, biochemical indicators of liver function have no significant advantages in the diagnosis of PHC, but they still have some values in the preliminary diagnosis of liver cancer through joint age, DBIL and ALA.
KEYWORDS: primary hepatocellular cancer (PHC); serum alpha-fetoprotein (AFP); common biochemical indicators

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