这项研究的目的是评估肝细胞癌（HCC）的诊断效率与α-1-岩藻糖苷酶（AFU）的联合分析，甲胎蛋白（AFP）和胸苷激酶1（TK1）。AFU的血清水平，在116例HCC患者中测量了AFP和TK1，109例良性肝病患者，104名正常人。使用逻辑回归方程和受试者工作特征曲线（ROC）分析诊断价值。各组中三种测试肿瘤标志物的统计分布是非正态分布的(Kolmogorov-Sminov检验,Z=0.156-0.517,P<0.001)。HCC患者血清AFP和TK1水平显著高于良性肝病患者(Mann-WhitneyU检验,Z=-8.570至-5.943，均P<0.001）。然而,两组之间的AFU无统计学差异(Mann-WhitneyU检验，Z=-1.820,P=0.069)。良性肝病患者的AFU水平明显高于正常人（Mann-WhitneyU检验，Z=-7.984,P<0.001)。HCC患者与无HCC患者的受试者工作特征曲线（ROC）表明AFU的最佳临界值为40.80U/L，AFP分别为10.86μg/L和TK1分别为1.92pmol/L。AFU的ROC曲线下面积（AUC）为0.718，法新社为0.832，TK1的0.773和三种肿瘤标志物的组合的0.900。该组合导致更高的Youden指数和85.3%的敏感度。血清AFU联合检测,AFP和TK1在HCC的诊断中可以起到补充作用，能显著提高HCC诊断的敏感性。
The purpose of this study was to evaluate the diagnostic efficiency for hepatocellular carcinoma (HCC) with the combined analysis of alpha-l-fucosidase (AFU), alpha-fetoprotein (AFP) and thymidine kinase 1 (TK1). Serum levels of AFU, AFP and TK1 were measured in: 116 patients with HCC, 109 patients with benign hepatic diseases, and 104 normal subjects. The diagnostic value was analyzed using the logistic regression equation and receiver operating characteristic curves (ROC). Statistical distribution of the three tested tumor markers in every group was non-normally distributed (Kolmogorov-Sminov test, Z = 0.156-0.517, P < 0.001). The serum levels of AFP and TK1 in patients with HCC were significantly higher than those in patients with benign hepatic diseases (Mann-Whitney U test, Z = -8.570 to -5.943, all P < 0.001). However, there was no statistically significant difference of AFU between these two groups (Mann-Whitney U test, Z = -1.820, P = 0.069). The levels of AFU were significantly higher in patients with benign hepatic diseases than in normal subjects (Mann-Whitney U test, Z = -7.984, P < 0.001). Receiver operating characteristic curves (ROC) in patients with HCC versus those without HCC indicated the optimal cut-off value was 40.80 U/L for AFU, 10.86 μg/L for AFP and 1.92 pmol/L for TK1, respectively. The area under ROC curve (AUC) was 0.718 for AFU, 0.832 for AFP, 0.773 for TK1 and 0.900 for the combination of the three tumor markers. The combination resulted in a higher Youden index and a sensitivity of 85.3%. The combined detection of serum AFU, AFP and TK1 could play a complementary role in the diagnosis of HCC, and could significantly improve the sensitivity for the diagnosis of HCC.
PDF(Sci-hub)