Analysis Of Diagnostic Cut-off Values And Related Factors Of AFP And AST/ALT In Hepatocellular Carcinoma And Hepatitis B-cirrhosis

Objective: To evaluate the clinical cut-off values of alpha fetoprotein(AFP)and the ratio of aspartate aminotransferase to alanine aminotransferase in the diagnosis of hepatitis B(HB),liver cirrhosis(LC)and hepatocellular carcinoma(HCC),To observe the changes of AFP,AST/ALT in patients with HB,LC and HCC after the standard treatment.For the diagnosis and prognosis of HCC,HB-LC,whether AFP and AST/ALT value combined application is better than used AFP alone.Methods: The values of AFP and AST/ALT of 200 patients of HCC from Xingtai infectious disease hospital,200 of HB-LC from the same one and 200 healthy persons from January 2006 to December 2015 were analyzed for case control study.The diagnostic critical points of AFP in 3 groups were got by statistical analysis.The relevance of AFP to AST/ALT were analyzed in 3 groups according to age and gender.The curative effects of patients of HB-LC and HCC were evaluated after the standard treatment for 3 months.Results:1 There was significant difference in AFP values between the normal group(3.30±3.47ng/ml),HB-LC group(184.49±181.14ng/ml)and HCC group(561.42±415.47ng/ml)(P<0.01),There was significant difference between the two groups.There was significant difference in AST/ALT between the normal group(1.35±0.51),HB-LC group(1.82±0.57)and HCC group(2.20±0.60)(P<0.01),There was significant difference between the two groups.2 The diagnostic critical point of AFP was 10.37 ng / ml between normal group and HB-LC group,and 320.81 ng / ml between HB-LC group and HCC group.3 There was no significant correlation between AFP and AST / ALT values in the normal group(r=0.08,P>0.05).There was a positive correlation between AFP and AST / ALT values in patients with hepatitis B and liver cirrhosis(r=0.72,P<0.01).AFP was positively correlated with AST / ALT values(r=0.68,P<0.01).4 There was no significant difference between values of AFP and AST / ALT and age in the normal group(P>0.05).There was significant difference between them in patients with hepatitis B-liver cirrhosis and those with HCC(P<0.01).And AFP and AST / ALT decreased correspondingly along with the ages in the two groups.5 After 3 months of standard treatment,both of AFP and AST / ALT values decreased in patients with HB-LC and HCC.And AFP values decreased more than AST / ALT,and the AFP values of patients with HCC decreased more than HB-LC(P<0.01).There was no significant difference in the values of AST/ALT between two groups after the standard treatment(P>0.05).Conclusions: The diagnostic critical point of AFP was 10.37 ng / ml between normal group and HB-LC group,and 320.81 ng / ml between HB-LC group and HCC group.Standard 3 months after treatment,the HB-LC and HCC group of AFP and AST/ALT values are falling,AFP value drop is greater than the AST/ALT decreased,HCC AFP value decline than HB-LC group AFP value decreased.The combination of serum AFP and AST / ALT is superior to the AFP alone for the diagnosis of HCC.