Study On The Application Of Combined Detection Of N-glycan,AFP And DCP In The Diagnosis Of Hepatitis B-related Hepatocellular Carcinoma

Objective:To explore the application value of separate and combined detection of serum N-glycan,α-fetoprotein(AFP)and des-γ-carboxy-prothrombin(DCP)in the diagnosis of hepatitis B-related hepatocellular carcinoma.Methods:Collected 85 patients with chronic hepatitis B virus infection-related liver disease,they were diagnosed in the Hepatobiliary and Pancreatic Department of the Second Hospital of Jilin University from April 2020 to November 2020,including 18 patients with chronic hepatitis B;22 patients with hepatitis B liver cirrhosis;23 patients with early hepatocellular carcinoma;22 patients with middle-advanced hepatocellular carcinoma;20 healthy people who underwent physical examinations in the physical examination center of the hospital during the same period were selected as normal controls.Detected the expression levels of N-glycan,AFP and DCP in the serum of each group by fluorescence capillary electrophoresis and electrochemiluminescence immunoassay.And analyzed the differences in the expression levels of the three serum markers among the above groups.And according to the different tumor-bearing status of hepatocellular carcinoma,the changes of the above three serum markers in patients with single and multiple hepatocellular carcinomas,patients with different size lesions of single hepatocellular carcinoma,patients with portal vein tumor thrombus,and patients with liver cirrhosis complicated with hepatocellular carcinoma were analyzed respectively.Using ROC curve to study the clinical application value of three serum markers alone and in combination in the diagnosis of hepatitis B-related hepatocellular carcinoma.Results:1.The expression of N-glycan,AFP and DCP in the early and middle-advanced hepatocellular carcinoma groups were significantly higher than those in the chronic hepatitis B group,the hepatitis cirrhosis group and the healthy control group(P<0.05).2.Under different tumor-bearing states of hepatocellular carcinoma,the expression levels of N-glycan,AFP and DCP in the multiple hepatocellular carcinoma group were significantly higher than those in the single hepatocellular carcinoma group(P<0.05),in the single hepatocellular carcinoma group,the expression levels increased with the increase of the tumor diameter,with a significant positive correlation,the r values were 0.676(P<0.01),0.550(P<0.05),0.653(P<0.01);The expression levels of patients with portal vein tumor thrombus were significantly higher than those of the non-portal vein tumor thrombus group(P<0.01);There was no significant difference in the expression level between the liver cirrhosis complicated with hepatocellular carcinoma group and non-cirrhosis complicated with hepatocellular carcinoma group(P>0.05).3.The clinical application value of separate and combined detection of N-glycan,AFP and DCP in the diagnosis of hepatitis B-related hepatocellular carcinoma.(1)Drew the ROC curve with the chronic hepatitis B + hepatitis cirrhosis group as the control.The area under the ROC curve of N-glycan,AFP and DCP in diagnosis of early hepatitis B-related hepatocellular carcinoma were 0.928 、 0.724 、 0.962,respectively.The corresponding optimal cut-off values were 4.985、18.825 ng/m L、31.625 m AU/m L.The sensitivities of N-glycan,AFP,DCP,three in parallel and three in series in diagnosing early hepatitis B-related hepatocellular carcinoma were 0.957、0.696、0.957、1.000、0.652,the specificities were 0.950、0.800、0.925、0.725、1.000,positive prediction rates were 0.917、0.667、0.880、0.676、1.000,and the negative prediction rates were 0.974、0.821、0.974、1.000、0.833,respectively.(2)Drew the ROC curve with the chronic hepatitis B + hepatitis cirrhosis group as the control.The area under the ROC curve of N-glycan,AFP and DCP in diagnosis of hepatitis B-related hepatocellular carcinoma were 0.940 、 0.819 、 0.977,respectively.The corresponding optimal cut-off values were 4.985、20.950 ng/m L、31.625 m AU/m L.The sensitivities of N-glycan,AFP,DCP,three in parallel and three in series in diagnosing early hepatitis B-related hepatocellular carcinoma were 0.956、0.822、0.956、1.000、0.756,the specificities were 0.950、0.825、0.925、0.725、1.000,positive prediction rates were 0.956、0.841、0.935、0.804、1.000,and the negative prediction rates were 0.950、0.805、0.949、1.000、0.784,respectively.Conclusion:1.The expression levels of N-glycan,AFP and DCP in the early and middle-advanced hepatocellular carcinoma groups were significantly higher than those in the chronic hepatitis B group,hepatitis cirrhosis group and the healthy control group.Revealed the change process of the above-mentioned markers at different stages of hepatocellular carcinoma,provided a theoretical basis for clarifying the basic research on the occurrence and development of hepatocellular carcinoma.2.The sensitivity and specificity of N-glycan for the diagnosis of hepatocellular carcinoma were significantly higher than those of AFP,and there was no difference compared with DCP.It showed that N-glycan had good clinical application value in screening and diagnosis of early hepatocellular carcinoma,especially in patients with low AFP expression.3.The combined application of N-glycan,AFP and DCP can significantly improve the efficiency of early diagnosis of hepatitis B-related hepatocellular carcinoma,especially when chronic hepatitis B progressed to liver cirrhosis,the sensitivity and specificity of combined detection in the diagnosis of early hepatocellular carcinoma are significantly better than those of separate detection,it is worthy of further clinical application.