【摘要】 目的 分析原发性肝癌诊断中使用异常凝血酶原Ⅱ+甲胎蛋白联合检测的价值。方法 目的选取2021年1月—2022年10月青岛市第六人民医院收治的180例肝病患者为研究对象，其中原发性肝癌（Primary hepatic carcinoma, HCC）患者60例（HCC组），肝炎患者60例（肝炎组），肝硬化患者60例（肝硬化组），所有患者均行异常凝血酶原Ⅱ（Abnormal ProthrombinⅡ, PIVKA-Ⅱ）及甲胎蛋白（Alpha Fetoprotein, AFP）检测，对比3组的指标水平差异，分析AFP检验、PIVKA-Ⅱ以及联合检测的诊断效能。结果 HCC组异常凝血酶原Ⅱ和甲胎蛋白高于其余两组，且肝硬化组高于慢性肝炎组，差异有统计学意义（P均<0.05）。联合检验的灵敏度96.66%、特异度91.66%和准确度93.33%明显高于AFP检验（81.66%、75.00%、77.22%）和PIVKA-Ⅱ检验（86.66%、82.50%、83.88%），差异有统计学意义（χ~2=6.792、11.882、18.318,P均<0.05）。结论 原发性肝癌患者的异常凝血酶原Ⅱ和甲胎蛋白水平较高，异常凝血酶原Ⅱ、甲胎蛋白联合检测较单一检测的诊断效能较高，能够提升临床诊断的灵敏度、特异度和准确度。更多还原

【Abstract】 Objective To analyze the value of abnormal prothrombin Ⅱ + alpha-fetoprotein combined detection in the diagnosis of primary liver cancer. Methods 180 patients with liver disease treated in the Sixth People’s Hospital of Qingdao from January 2021 to October 2022 were purposefully selected as the study objects, including 60 patients with primary hepatic carcinoma(HCC group) and 60 patients with hepatitis(hepatitis group) and 60 patients with cirrhosis(cirrhosis group). Abnormal prothrombin Ⅱ(PIVKA-Ⅱ) and alpha fetoprotein(AFP) were detected in all patients. The diagnostic efficiency of AFP test, PIVKA-Ⅱ and combined test was analyzed. Results Abnormal prothrombin Ⅱ and alpha-fetoprotein in HCC group were higher than those in other two groups, and liver cirrhosis group was higher than chronic hepatitis group, the differences were statistically significant(all P<0.05). The sensitivity of the combined test was 96.66%, specificity 91.66% and accuracy 93.33%, which were significantly higher than AFP test(81.66%, 75.00%, 77.22%) and PIVKA-Ⅱ test(86.66%, 82.50%, 83.88%),and the difference were statistically significant(χ~2=6.792, 11.882, 18.318, all P<0.05). Conclusion Abnormal prothrombin Ⅱ and alpha-fetoprotein levels are higher in patients with primary liver cancer, and the combined detection of abnormal prothrombin Ⅱ and alpha-fetoprotein has higher diagnostic efficacy than single detection, which can improve the sensitivity, specificity and accuracy of clinical diagnosis.更多还原