血清M2BPGi和AFP联合检测对肝细胞癌的诊断价值

摘要/Abstract

摘要： 目的探讨血清Mac-2结合蛋白糖基化异构体(M2BPGi)水平与甲胎蛋白(AFP)联合检测对肝细胞癌(HCC)的诊断价值。方法基于倾向性评分匹配原则纳入2016年1月至2020年10月苏州大学附属第一医院收治的111例HCC患者,142例肝硬化患者和95例慢性乙型肝炎患者,同期从体检中心选取97名健康对照者。根据BCLC分期系统将0期和A期定义为早期HCC。血清学M2BPGi检测采用夹心法试剂盒化学发光酶联免疫测定。统计学方法包括:二分类变量logistic回归分析,并建立新变量(预测概率);对单项指标、联合检测进行受试者工作特征(ROC)曲线分析,评估单项及联合检测的ROC下面积(AUC)、敏感度及特异度。结果 HCC组血清M2BPGi水平为3.68(2.65,5.00)COI,高于健康对照组的1.63(1.34,1.90)COI、慢性乙型肝炎组1.77(1.23,2.16)COI及肝硬化组1.93(1.54,2.50)COI,差异有统计学意义(U=105.8,P<0.01)。经校正后,血清M2BPGi水平与HCC发病风险呈正相关(OR=2.331, 95% CI:1.756~3.096, P<0.01)。AFP和M2BPGi联合检测诊断HCC的AUC为0.929,95% CI:0.901 ~0.956,敏感度为0.901,特异度为0.823,准确度0.843,其判断效力高于AFP及M2BPGi单独检测(均P<0.01)。联合检测诊断早期HCC的AUC为0.923,95% CI: 0.887~0.960,敏感度为0.900,特异度为0.823,准确度0.837,高于两项单独检测(均P<0.01)。结论血清M2BPGi是HCC发病的独立危险因素。联合AFP检测可提高诊断敏感性,为HCC人群筛查及早期诊断提供新思路。

关键词: 肝细胞癌, Mac-2结合蛋白糖基化异构体, 甲胎蛋白, 肿瘤标记物, 真实世界数据

Abstract: Objective To investigate the association between serum mac-2 binding protein glycan isomer (M2BPGi) level and the risk of hepatocellular carcinoma (HCC). And to investigate the value of serum M2BPGi combined with AFP in diagnosing HCC. Methods One hundred and eleven patients with HCC, 142 patients with cirrhosis and 95 patients with chronic hepatitis B (CHB) admitted to our hospital from January 2016 to October 2020 were included. Ninety-seven healthy controls were selected from physical examination center during the same period. The phase 0 and A were defined as the early HCC according to the Barcelona Clinic Liver Cancer (BCLC) classification. Serum level of M2BPGi was detected by enzyme-linked immunosorbent assay (ELISA). Binary logistic regression analysis was used to establish new variable (predicting probability). Receiver operator characteristic (ROC) curve was used to analyze the biomarkers, the area under the curve (AUC), sensitivity and specificity were evaluated. Results Serum M2BPGi level of HCC group (3.68 [2.65-5.00] C.O.I) was significantly higher than that of healthy control group (1.63 [1.34-1.90] C.O.I), CHB group (1.77 [1.23-2.16] C.O.I) and cirrhosis group (1.93 [1.54-2.50] C.O.I) (all P<0.001). After adjusting, serum level of M2BPGi was positively correlated with the risk of HCC (odd ratio 2.331, 95% CI [1.756-3.096], P<0.001). The model of serum AFP combined with M2BPGi predicting HCC was established ([AUC] 0.929, 95% CI [0.901-0.956], sensitivity 0.901, specificity 0.823, accuracy 0.843), its diagnosing value was better than AFP or M2BPGi alone (both P<0.001). The prediction model in diagnosing early HCC (AUC 0.923 [95% CI 0.887-0.960], sensitivity 0.900, specificity 0.823, accuracy 0.837) performed better than AFP (P=0.003) or M2BPGi (P<0.001) alone. Conclusion Serum M2BPGi is an independent risk factor for HCC. M2BPGi combined with AFP can improve diagnostic sensitivity in diagnosing HCC, which offers new insights in screening and early diagnosis of HCC.

Key words: Hepatocellular carcinoma, Mac-2 binding protein glycan isomer, Alpha-fetoprotein, Tumor biomarker, Real-world data

洪钰, 梁爽, 朱锦舟. 血清M2BPGi和AFP联合检测对肝细胞癌的诊断价值[J]. 肝脏, 2021, 26(12): 1320-1323.

HONG Yu, LIANG Shuang, ZHU Jin-zhou. The value of serum M2BPGi combined with AFP in diagnosing hepatocellular carcinoma[J]. Chinese Hepatolgy, 2021, 26(12): 1320-1323.

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