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目的:探索血清Dickkopf1(DKK1)水平对原发性肝癌(PLC)的诊断价值。方法:将我院收治的50例PLC患者、60例良性肝病患者、50例健康体检者及50例其它恶性肿瘤患者分别组成PLC组、良性肝病组、健康对照组及其他肿瘤组,采用ELISA定量检测各组血清DKK1蛋白的浓度,分析和比较其与α-fetoprotein(AFP)单独或联合诊断PLC的效能。结果:PLC组血清DKK1水平(838.96±104.14 ng/L)明显高于良性肝病组(322.61±25.44 ng/L)及健康对照组(213.03±25.70 ng/L),差异有统计学意义(P<0.05)。AFP、DKK1单独鉴别诊断PLC和良性肝病的灵敏度分别为66%、46%,特异度分别为81.7%、96.7%,一致率分别为71.8%、73.6%;两者联合诊断的灵敏度、特异度及一致率分别为84%、78.3%、80.9%。AFP、DKK1联合诊断PLC的灵敏度和一致率均明显高于AFP、DKK1单独诊断。结论:血清DKK1在原发性肝癌中高表达,与原发性肝癌的发生密切相关,对PLC的早期诊断有一定参考价值,与AFP联合诊断可有效提高PLC的诊断效能。
Objective: To explore the diagnostic value of serum Dickkopf1 (DKK1) level in patients with primary liver cancer (PLC). Methods: Fifty patients with PLC, 60 patients with benign liver disease, 50 healthy subjects and 50 patients with other malignant tumors were enrolled in this study. The patients in PLC group, benign liver disease group, healthy control group and other tumor groups were determined by ELISA The concentrations of DKK1 protein in serum of each group were detected, and their efficacy in diagnosing PLC alone or in combination with α-fetoprotein (AFP) was analyzed and compared. Results: Serum DKK1 level in PLC group (838.96 ± 104.14 ng / L) was significantly higher than that in benign liver disease group (322.61 ± 25.44 ng / L) and healthy control group (213.03 ± 25.70 ng / L) (P < 0.05). The sensitivity of AFP and DKK1 in the differential diagnosis of PLC and benign liver disease were 66% and 46% respectively, and the specificity was 81.7% and 96.7% respectively. The concordance rates were 71.8% and 73.6% respectively. The sensitivity, specificity, The agreement rates were 84%, 78.3% and 80.9% respectively. AFP, DKK1 combined diagnostic PLC sensitivity and consistency were significantly higher than AFP, DKK1 alone diagnosis. Conclusion: Serum DKK1 is highly expressed in primary hepatocellular carcinoma (HCC), which is closely related to the occurrence of primary hepatocellular carcinoma (HCC). It has some reference value for the early diagnosis of PLC. Combined diagnosis with AFP can effectively improve the diagnostic efficacy of PLC.