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本文对66例B型超声实时显像显示肝脏有占位性病变患者,手术前同时进行血清铁蛋白、α_1抗胰蛋白酶及甲胎蛋白测定。以阳性预示值及特异性为优先考察指标,兼顾Youden指数及诊断效率,确定血清铁蛋白的切割值男性为300μg/L,女性为180μg/L,α_1抗胰蛋白酶及甲胎蛋白的切割值分别为4.2 g/L及20μg/L。其中55例肝癌患者的血清铁蛋白、α_1抗胰蛋白酶及甲胎蛋白的阳性率分别为0.84、0.71及0.66,但组合分析表明三者均阴性可基本排除肝癌可能,甲胎蛋白阳性可排除肝血管瘤可能。因此组合分析对肝癌的诊断及肝癌与肝做管瘤的鉴别诊断是可取的。
In this paper, 66 cases of B-ultrasound real-time imaging showed that patients with space-occupying lesions in the liver, serum ferritin, α_1 antitrypsin and alpha fetoprotein were measured before surgery. Taking the positive predictive value and specificity as the priority indicators, taking into account the Youden index and diagnostic efficiency, the cutoff value of serum ferritin was determined to be 300 μg/L for men and 180 μg/L for women, and the cut values of α_1 antitrypsin and alpha-fetoprotein were respectively It is 4.2 g/L and 20 μg/L. The positive rates of serum ferritin, α_1 antitrypsin, and alpha fetoprotein in 55 patients with liver cancer were 0.84, 0.71, and 0.66, respectively. However, the combination analysis showed that the three were negative and basically excluded the possibility of liver cancer. AFP was positive and could exclude liver. Hemangioma may be. Therefore, combinatorial analysis is advisable for the diagnosis of liver cancer and the differential diagnosis of hepatocellular carcinoma and hepatoblastoma.