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中华普通外科学文献(电子版) ›› 2016, Vol. 10 ›› Issue (04) : 294 -297. doi: 10.3877/cma.j.issn.1674-0793.2016.04.015

所属专题: 文献

论著

多指标联合检测在肝癌筛查中的可行性研究
孙浩1, 季明芳2, 张常华3, 胡泽民2, 冯谦谨2, 余元龙2,()   
  1. 1. 510800 广州,中山大学附属第一医院普外科;528400 中山市人民医院肝胆外科
    2. 528400 中山市人民医院肝胆外科
    3. 510800 广州,中山大学附属第一医院普外科
  • 收稿日期:2016-06-10 出版日期:2016-08-01
  • 通信作者: 余元龙
  • 基金资助:
    中央补助地方公共卫生专项资金癌症早诊早治资助项目(2012)

Multi-index joint detection feasibility study for hepatocacinoma screening

Hao Sun1, Mingfang Ji2, Changhua Zhang3, Zemin Hu2, Qianjin Feng2, Yuanlong Yu2,()   

  1. 1. Department of General Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; Department of Hepatobiliary Surgery, Zhongshan People's Hospital, Guangzhou 528400, China
    2. Department of Hepatobiliary Surgery, Zhongshan People's Hospital, Guangzhou 528400, China
    3. Department of General Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2016-06-10 Published:2016-08-01
  • Corresponding author: Yuanlong Yu
  • About author:
    Corresponding author: Yu Yuanlong, Email:
引用本文:

孙浩, 季明芳, 张常华, 胡泽民, 冯谦谨, 余元龙. 多指标联合检测在肝癌筛查中的可行性研究[J]. 中华普通外科学文献(电子版), 2016, 10(04): 294-297.

Hao Sun, Mingfang Ji, Changhua Zhang, Zemin Hu, Qianjin Feng, Yuanlong Yu. Multi-index joint detection feasibility study for hepatocacinoma screening[J]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(04): 294-297.

目的

探索乙肝表面抗原(HBsAg)、抗丙型肝炎病毒(Anti-HCV)、HBV-DNA和甲胎蛋白(AFP)多指标联合检测在肝癌筛查中的可行性。

方法

选择2014年5月至2015年10月中山市人民医院肝胆外科收治的原发性肝癌患者139例为病例组。在2012年中山市肝癌筛查队列人群中按年龄±5和性别以4∶1与病例组随机匹配,选择对照样本556人纳入对照组;采用酶联免疫吸附(ELISA)法检测研究对象血清标本中HBsAg、Anti-HCV和AFP;运用PCR体外扩增荧光定量(FQ-PCR)法检测血清HBV-DNA;比较两组四项指标的阳性率,探讨单指标和多指标联合检测在肝癌筛查中的敏感度、特异度和漏检率。

结果

单一指标筛查时,AFP敏感度最高,其次为HBsAg。以HBsAg为主体的联合筛查,不同指标联合筛查有不同的敏感度和漏检率,以HBsAg、Anti-HCV、AFP联合HBV-DNA的敏感度最高,漏检率最低;其次为HBsAg、AFP联合HBV-DNA;再次为HBsAg、Anti-HCV联合AFP。

结论

联合检测HBsAg、Anti-HCV和AFP进行初筛,可以极大地提高肝癌高危人群的早期筛查效果。

Objective

To explore the feasibility of multi-index joint detection of hepatitis B surface antigen (HBsAg), Anti-hepatitis C virus (Anti-HCV), HBV-DNA and alpha-fetoprotein (AFP) for screening liver cancer.

Methods

From May 2014 to October 2015, one hundred and thirty-nine cases with hepatocellular carcinoma in Zhongshan People's Hospital were selected as case group. At the same time, 556 cases were chosen as control group by age±5 and gender in the ratio of 4:1 randomly matched group cases in Zhongshan Gity liver cancer screening research in 2012. HBsAg, Anti-HCV and AFP in serum were detected by enzyme-linked immunosorbent assay (ELISA). FQ-PCR method was used to detect HBV-DNA in serum samples. Positive rate of single index indicators in the two groups, and the sensitivity, specificity, and false negative rate of multiple-index combined detection were explored in hepatocarcinoma screening.

Results

AFP sensitivity was the best for single index screening, followed by HBsAg. When HBsAg was used as the main body of the combined screening, the combination of different indicators had different sensitivity, with the miss rate of HBsAg, Anti-HCV, and AFP joined by HBV-DNA having the best sensitivity and the lowest miss rate; followed by HBsAg, AFP joined by HBV-DNA; and by HBsAg, Anti-HCV joined by AFP.

Conclusion

Combined detection of HBsAg, Anti-HCV and AFP screening can improve the early screening effect of high-risk liver cancer patients.

表1 两组肝癌筛查人群的指标检测阳性结果[例/人(%)]
表2 两组HBsAg(-)人群中其他指标检测阳性结果[例/人(%)]
表3 四种指标单独用于肝癌筛查的真实性评价[例/人(%)]
表4 四种指标不同联合检测方案用于肝癌筛查的真实性评价
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