{"title":"甲胎蛋白和超声波在肝细胞肝癌患者的诊断和预后中的作用","authors":"Dongfang Huang, Jianhuai Zhang, Jianbo Xu, Qiang Niu, Dinghua Zhou","doi":"10.2147/jmdh.s449276","DOIUrl":null,"url":null,"abstract":"Objective: To investigate the utility of alpha-fetoprotein (AFP) and ultrasound in the diagnosis and prognosis of patients with hepatocellular liver cancer (HCC). Methods: Using retrospective convenience sampling, 401 patients with HCC who underwent transarterial chemoembolisation at the Department of Oncology of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University between June 2015 and January 2020 were recruited and assigned to the case group. Simultaneously, patients matched to the case group in terms of gender and age but excluded for HCC were enrolled at a 1:1 ratio and classified as the control group. Relevant parameters were collected from both groups for comparison. Results: Both AFP levels and ultrasound results demonstrated diagnostic value for patients with HCC ( P < 0.05). Their combined use exhibited the highest diagnostic accuracy for the cancer, with an area under the curve of 0.896 (95% confidence interval [CI]: 0.876, 0.923), a sensitivity of 67.65% and a specificity of 91.22%. In terms of overall survival (OS), statistically significant differences in the OS rates were observed between the low-AFP (L-AFP) group and high-AFP (H-AFP) group as well as between the low-tumour-diameter (LTD) group and high-tumour-diameter (HTD) group (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Regarding the progression-free survival (PFS), significant differences in the PFS rates were also noted between the L-AFP and H-AFP groups and between the LTD and HTD groups (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Conclusion: Ultrasound and AFP display notable distinctions when used in the diagnosis of HCC. The sensitivity of ultrasound as a standalone diagnostic tool surpasses that of AFP alone. However, their combined use results in much higher specificity than the use of either test individually. In addition, both techniques hold predictive value for patients’ OS and PFS, enabling timely prognostic assessment.","PeriodicalId":505971,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"43 15","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Utility of Alpha-Fetoprotein and Ultrasound in the Diagnosis and Prognosis of Patients with Hepatocellular Liver Cancer\",\"authors\":\"Dongfang Huang, Jianhuai Zhang, Jianbo Xu, Qiang Niu, Dinghua Zhou\",\"doi\":\"10.2147/jmdh.s449276\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: To investigate the utility of alpha-fetoprotein (AFP) and ultrasound in the diagnosis and prognosis of patients with hepatocellular liver cancer (HCC). Methods: Using retrospective convenience sampling, 401 patients with HCC who underwent transarterial chemoembolisation at the Department of Oncology of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University between June 2015 and January 2020 were recruited and assigned to the case group. Simultaneously, patients matched to the case group in terms of gender and age but excluded for HCC were enrolled at a 1:1 ratio and classified as the control group. Relevant parameters were collected from both groups for comparison. Results: Both AFP levels and ultrasound results demonstrated diagnostic value for patients with HCC ( P < 0.05). Their combined use exhibited the highest diagnostic accuracy for the cancer, with an area under the curve of 0.896 (95% confidence interval [CI]: 0.876, 0.923), a sensitivity of 67.65% and a specificity of 91.22%. In terms of overall survival (OS), statistically significant differences in the OS rates were observed between the low-AFP (L-AFP) group and high-AFP (H-AFP) group as well as between the low-tumour-diameter (LTD) group and high-tumour-diameter (HTD) group (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Regarding the progression-free survival (PFS), significant differences in the PFS rates were also noted between the L-AFP and H-AFP groups and between the LTD and HTD groups (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Conclusion: Ultrasound and AFP display notable distinctions when used in the diagnosis of HCC. The sensitivity of ultrasound as a standalone diagnostic tool surpasses that of AFP alone. However, their combined use results in much higher specificity than the use of either test individually. In addition, both techniques hold predictive value for patients’ OS and PFS, enabling timely prognostic assessment.\",\"PeriodicalId\":505971,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":\"43 15\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/jmdh.s449276\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/jmdh.s449276","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的研究甲胎蛋白(AFP)和超声波在肝细胞性肝癌(HCC)患者的诊断和预后中的作用。方法:采用回顾性方便抽样法:采用回顾性便利抽样法,招募2015年6月至2020年1月期间在南京医科大学附属淮安市第一人民医院肿瘤科接受经动脉化疗栓塞术的401例HCC患者,并将其分配至病例组。同时,按1:1的比例招募与病例组性别和年龄相匹配但排除了HCC的患者作为对照组。收集两组患者的相关参数进行比较。结果:甲胎蛋白水平和超声结果对 HCC 患者均有诊断价值(P < 0.05)。两者结合使用对癌症的诊断准确率最高,曲线下面积为 0.896(95% 置信区间 [CI]:0.876, 0.923),敏感性为 67.65%,特异性为 91.22%。在总生存期(OS)方面,低AFP(L-AFP)组与高AFP(H-AFP)组之间以及低肿瘤直径(LTD)组与高肿瘤直径(HTD)组之间的OS率差异有统计学意义(分别为81.31% vs 52.22%和85.11% vs 63.41%;P < 0.05)。在无进展生存期(PFS)方面,L-AFP组和H-AFP组之间以及LTD组和HTD组之间的PFS率也存在显著差异(分别为81.31% vs 52.22%和85.11% vs 63.41%;P < 0.05)。结论超声和 AFP 在诊断 HCC 时有明显的区别。超声作为独立诊断工具的灵敏度超过了单独使用 AFP 的灵敏度。不过,两者联合使用的特异性要比单独使用其中一种检测方法高得多。此外,这两项技术对患者的手术期和生存期都有预测价值,可以及时进行预后评估。
Utility of Alpha-Fetoprotein and Ultrasound in the Diagnosis and Prognosis of Patients with Hepatocellular Liver Cancer
Objective: To investigate the utility of alpha-fetoprotein (AFP) and ultrasound in the diagnosis and prognosis of patients with hepatocellular liver cancer (HCC). Methods: Using retrospective convenience sampling, 401 patients with HCC who underwent transarterial chemoembolisation at the Department of Oncology of The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University between June 2015 and January 2020 were recruited and assigned to the case group. Simultaneously, patients matched to the case group in terms of gender and age but excluded for HCC were enrolled at a 1:1 ratio and classified as the control group. Relevant parameters were collected from both groups for comparison. Results: Both AFP levels and ultrasound results demonstrated diagnostic value for patients with HCC ( P < 0.05). Their combined use exhibited the highest diagnostic accuracy for the cancer, with an area under the curve of 0.896 (95% confidence interval [CI]: 0.876, 0.923), a sensitivity of 67.65% and a specificity of 91.22%. In terms of overall survival (OS), statistically significant differences in the OS rates were observed between the low-AFP (L-AFP) group and high-AFP (H-AFP) group as well as between the low-tumour-diameter (LTD) group and high-tumour-diameter (HTD) group (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Regarding the progression-free survival (PFS), significant differences in the PFS rates were also noted between the L-AFP and H-AFP groups and between the LTD and HTD groups (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Conclusion: Ultrasound and AFP display notable distinctions when used in the diagnosis of HCC. The sensitivity of ultrasound as a standalone diagnostic tool surpasses that of AFP alone. However, their combined use results in much higher specificity than the use of either test individually. In addition, both techniques hold predictive value for patients’ OS and PFS, enabling timely prognostic assessment.