RESUMO
Objective To investigate the expression level of protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in serum of primary liver cancer patients with HBV infection and combined with alphafetoprotein (AFP) and AST/ALT ratio in the diagnosis of primary liver cancer with HBV infection.Methods Sera of 68 HBV infection patients with primary liver cancer were collected.Meanwhile, sera of 109 HBV infection patients (8 cases of gallbladder diseases, 94 cases of benign liver diseases, 7 csaes of other organ diseases) were collected as controls.The serum levels of PIVKA-Ⅱand AFP were detected by the method of chemiluminescent immunoassay and electrochemical luminescence respectively.The rate method was used to detect the content of AST and ALT, and the ratio of AST/ALT was calculated.Compared the expression level of tumor markers in each group, and the receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic efficacy of individual and combined application of each index in the diagnosis of primary liver cancer.Results The sera levels of PIVKA-Ⅱ, AFP and AST/ALT ratio in primary liver cancer with HBV infection group were all higher than those in control group (P＜0.01).ROC curve analysis showed that with the critical value of PIVKA-Ⅱ, AFP and AST/ALT ratio in serum were 100.42 mAu/mL, 232.35 ng/mL and 1.571 in the diagnosis of primary liver cancer with HBV infection, the area under the ROC curve (AUC) were 0.942, 0.786 and 0.723 respectively;the sensitivity were 89.70％, 58.80％and 51.50％;the specificity were 91.70％, 88.10％and 79.80％.The AUC of PIVKA-Ⅱcombined with AST/ALT ratio in the diagnosis of primary liver cancer with HBV infection was 0.955, the sensitivity and specificity wree 86.80％and 93.40％respectively.Conclusion The value of PIVKA-II in the diagnosis of primary liver cancer with HBV infection is obviously better than that of AFP and AST/ALT ratio.The combined detection with AST/ALT ratio will be helpful to improve the diagnostic efficacy of primary liver cancer with HBV infection.
RESUMO
Objective To carry out a systematic evaluation for the diagnostic accuracy of Des-γ-carboxy-prothrombin(DCP) in primary hepatocellular cancer(PHC) by Meta-analysis.Methods The published international and domestic studies on DCP in the diagnosis of PHC were searched in multiple databases from its inception until December 2016.A total of seventeen studies were finally selected,among which 1 970 cases of PHC group and 2 588 cases of control group were included.The control group was composed of chronic hepatitis,cirrhosis,tumors in other systems and healthy subjects with physical examination.A meta-analysis was performed using Stata 12.0.Results The overall pooled results of the analysis and the 95％ confidence intervals were as follows:the sensitivity(SEN) was 0.79 (0.74 to 0.83),the specificity (SPE) was 0.90 (0.87 to 0.93),the positive likelihood ratio(PLR) was 8.1 (5.8 to 11.1),the negative likelihood ratio(NLR) was 0.24(0.19 to 0.29),the diagnostic odds ratio(DOR) was 34(21 to 55) and the area under the summary receiver operator characteristic curve (SROC) was 0.91 (0.89 to 0.93).The sensitivity combined the detections of AFP and DCP in the diagnosis of PHC was 0.90 with 0.94 of AUCROC and 56 of DOR.Conclusion The serum DCP may exhibit a relatively higher diagnostic specificity for PHC.The combined detections of AFP and DCP could improve the sensitivity and diagnostic accuracy.