| Objective To investigate the clinical value of protein induced by vitamin K absence or antagonist-II(PIVKA-?),Golgi protein 73(GP73)and lens culinaris agglutinin-reactive fraction of AFP(AFP-L3)in hepatocellular carcinoma(HCC).Methods A total of 175 HCC patients from our hospital from November 2017 to November 2018 were selected as the study group and the patients with liver cirrhosis,hepatitis and health examination as the control group.There were 55 patients in the hepatocellular carcinoma group,40 in the cirrhosis group,40 in the hepatitis group,and40 in the healthy group included in the study,and the cirrhosis and hepatitis groups were considered as the benign liver disease group.The basic information and pathological data of the study subjects were collected in detail.The content of PIVKA-?and AFP was detected by chemiluminescence microparticle immunoassay,the content of GP73 was detected by enzyme-linked immunosorbent assay,the AFP-L3 affinity adsorption centrifuge tube was used in combination with AFP quantitative detection kit,and the ratio of AFP-L3 to total AFP(AFP-L3%)was calculated.According to Child-Pugh liver function classification,Barcelona(BCLC)stage,tumor differentiation and tumor size,HCC were divided into different groups,and the relationship between PIVKA-?,GP73,AFP-L3%,AFP and HCC clinicopathology was analyzed and compared.ROC curves were plotted separately and in combination to calculate the area under the curve(AUC)and compare its value in the diagnosis of HCC.The correlations between PIVKA-?,GP73,and AFP-L3% and AFP were analyzed by Spearman correlation analysis.Results(1)The proportions of AFP positive,PIVKA-? positive,GP73 positive and AFP-L3 positive in HCC group were significantly higher than those in control group(P<0.05).(2)The results of PIVKA-?,AFP,GP73 and AFP-L3% in HCC and cirrhosis,hepatitis and health groups were different(P<0.05).(3)Plasma PIVKA-? concentration was higher in BCLC stage C,poorly differentiated tumors,and tumor diameter greater than 5 cm(P<0.05);Plasma GP73 concentration was higher in Child-Pugh liver function grade B,BCLC stage C,poorly differentiated tumors,and tumor diameter greater than5cm(P<0.05);there was no correlation between plasma AFP-L3%,AFP and Child-Pugh grade,BCLC stage,tumor differentiation,and tumor diameter(P>0.05).(4)When AFP<20 ng/ml,the plasma PIVKA-? concentration,GP73 concentration and AFP-L3 ratio in HCC group were higher than those in benign liver disease group(P<0.05);when AFP was between 20ng/ml and 400 ng/ml,the plasma PIVKA-? concentration and AFP-L3 ratio in HCC group were higher than those in benign liver disease group(P<0.05),but there was no significant difference in GP73 concentration(P>0.05);when AFP>400ng/ml,the plasma PIVKA-? concentration,GP73 concentration and AFP-L3 ratio in HCC group were higher than those in benign liver disease group(P>0.05).(5)ROC curve analysis showed that the AUC(95% CI)of PIVKA-?,AFP,GP73 and AFP-L3% in the differential diagnosis of HCC and non-HCC was 0.864(0.797-0.915),0.846(0.777-0.901),0.788(0.713-0.852)and 0.788(0.713-0.852)respectively;the sensitivity was 69.1%,61.8%.(6)By Spearman correlation analysis,PIVKA-?,GP73 and AFP-L3% were correlated with AFP.Conclusion 1.PIVKA-?,GP73,AFP-L3 can be used for the auxiliary diagnosis of HCC;2.PIVKA-? and GP73 were correlated with tumor stage,tumor differentiation and tumor size.3.When PIVKA-?,GP73 and AFP-L3 were used alone to diagnose HCC,PIVKA-? had the best diagnostic performance;PIVKA-? combined with AFP had the best diagnostic performance. |
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