|本期目录/Table of Contents|

[1]周冷潇,韩 涛,刘 芳.无创肝纤维化指标结合甲胎蛋白对乙型肝炎相关肝细胞癌的评估[J].天津医科大学学报,2017,23(05):415-418.
 ZHOU Leng-xiao,HAN Tao,LIU Fang.Assessment of non-invasive fibrosis indexes with alpha-fetoprotein?for? hepatitis B virus-related hepatocellular carcinoma[J].Journal of Tianjin Medical University,2017,23(05):415-418.
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无创肝纤维化指标结合甲胎蛋白对乙型肝炎相关肝细胞癌的评估(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23
期数:
2017年05期
页码:
415-418
栏目:
临床医学
出版日期:
2017-09-20

文章信息/Info

Title:
Assessment of non-invasive fibrosis indexes with alpha-fetoprotein?for? hepatitis B virus-related hepatocellular carcinoma
文章编号:
1006-8147(2017)05-0415-04
作者:
周冷潇12韩 涛12刘 芳12
(1.天津医科大学三中心临床学院肝内科,天津 300170; 2. 天津市第三中心医院肝内科,天津 300170)
Author(s):
ZHOU Leng-xiao12 HAN Tao12 LIU Fang12
(1.Department of Hepatology, The Third Central Clinical College , Tianjin Medical University, Tianjin 300170, China; 2. Department of Hepatology, The Third Central Hospital of Tianjin, Tianjin 300170, China)
关键词:
肝纤维化指标肝炎乙型肝硬化肝细胞癌
Keywords:
fibrosis index hepatitis B liver cirrhosis hepatocellular carcinoma
分类号:
R575
DOI:
-
文献标志码:
A
摘要:
目的: 探讨无创肝纤维化指标结合甲胎蛋白(AFP)对乙肝相关肝细胞癌(HCC)的评估价值。方法: 收集慢性乙型肝炎患者423例,包括218例乙肝肝硬化患者(肝硬化组)和205例乙肝相关HCC患者(HCC组)。收集患者年龄的临床资料,检测患者外周血血小板(PLT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、AFP,并计算AST/ PLT比值指数(APRI)、AST/ALT比值(AAR)、基于4因子的肝纤维化指标(FIB-4)、年龄/PLT计数指数(AP指数)。相关性分析采用Spearman相关分析,用灵敏度判断上述指标对乙肝相关HCC的评估价值。结果: 对所有患者而言,肝硬化组APRI、AAR、FIB-4、AP指数及AFP指标水平显著低于HCC组(P<0.05)。如按照年龄段分层,年龄<50岁患者中肝硬化组FIB-4及AFP指标水平较HCC组显著偏低(P<0.05);50~59岁患者中肝硬化组APRI、FIB-4、AP指数及AFP指标水平显著低于HCC组(P<0.05);年龄≥60岁患者中FIB-4、AP指数及AFP指标水平较HCC组显著偏低(P<0.05);各个年龄段两组其余指标水平相比没有显著差异(P>0.05)。对所有患者,AFP、AFP结合APRI、AFP结合FIB-4、AFP结合AP指数预测乙肝相关HCC的灵敏度分别为76.19%、84.52%、83.93%、91.07%;年龄<50岁者,AFP、AFP结合FIB-4指标预测的灵敏度分别为90.63%、93.75%;50~59岁者,AFP、AFP结合APRI、AFP结合FIB-4预测的灵敏度分别为70.51%、84.26%、83.33%;年龄≥60岁者,AFP、AFP结合FIB-4、AFP结合AP指标预测的灵敏度分别为72.41%、79.31%、94.83%。结论: 虽然不同年龄段存在一定差异,但总体上AFP结合APRI、AFP结合FIB-4及AFP结合AP指数与乙肝相关HCC密切相关,对乙肝相关HCC预测的灵敏度优于单独使用AFP。
Abstract:
Objective: To investigate the non-invasive fibrosis indexes with alpha-fetoprotein (AFP) in patients with Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods: A total of 423 patients with chronic hepatitis B were enrolled and divided into two groups: 218 patients with HBV-related cirrhosis as the cirrhosis group and 205 patients with HBV-related HCC as the HCC group. Age, platelet (PLT), alanine aminotransferase (ALT), aspatate aminotransferase (AST) and AFP were tested and AST to PLT ratio index (APRI), aspartate-alanine aminotrasferase ratio (AAR), fibrosis index based on the 4 factor (FIB-4) and Age/PLT index (AP Index) were calculated. Spearman correlation was used to evaluate the associations between HBV-related HCC and these indexes. The sensitivities were calculated to assess the performance of these indexes in predicting HBV-related HCC. Results: APRI, AAR, FIB-4, AP Index and AFP of the cirrhosis group were significantly lower than HCC group for all patients (P<0.05). The HCC group had significantly higher FIB-4 and AFP than the cirrhosis group younger than 50 higher APRI, FIB-4, AP Index and AFP aging from 50 to 59, and higher FIB-4, AP Index and AFP greater than or equal to 60 than cirrhosis group (P<0.05), while others had no statistical significant differences between two groups (P>0.05). The sensitivities of AFP, AFP with APRI, AFP with FIB-4, AFP with AP Index of all ages were 76.19%, 84.52%, 83.93% and 91.07% respectively. The sensitivities of AFP and AFP with FIB-4 less than 50, AFP, AFP with APRI and AFP with FIB-4 from 50 to 59, and AFP, AFP with FIB-4 and AFP with AP Index 60 years or older were 90.63%, 93.75%, 70.51%, 84.26%,83.33%, 72.41%, 79.31% and 94.83% respectively, Conclusion: Although there are differences between different ages, generally AFP with APRI, AFP with AAR, AFP with FIB-4 and AFP with AP Index are closely correlated with HBV-related HCC and all of them may be superior to AFP in sensitivity of HBV-related HCC.

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备注/Memo

备注/Memo:

基金项目  国家科技重大专项基金资助(2016ZX10002008-07);天津市科技计划项目(13RCGFSY19200)

作者简介  周冷潇(1991-),女,硕士在读,研究方向:主要从事肝脏相关疾病研究;通信作者 :韩涛 , E-mail:hantaomd@126.com。

更新日期/Last Update: 2017-09-20