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Diagnostic value of gamma-glutamyltransferase/aspartate aminotransferase ratio, protein induced by vitamin K absence or antagonist II, and alpha-fetoprotein in hepatitis B virus-related hepatocellular carcinoma

查看全文 作　　者：Qiang [1,2]Wang;Qi [3]Chen;Xia [4]Zhang;Xiao-Lan [1]Lu;Qin [1]Du;Tao [5]Zhu;Guo-Yuan [1]Zhang;Dong-Sheng [1]Wang;Qu-Ming [1]Fan 高影响力作者 机构地区：[1]Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;[2]Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;[3]Department of Laboratory Medicine, Affiliated Sichuan Ba-Yi Rehabilitation Center of Chengdu University of TCM, Chengdu 610000, Sichuan Province, China;[4]Department of Laboratory Medicine of the Ninth People’s Hospital of Chongqing, Chongqing 400700, China;[5]Department of Preventive Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China高影响力机构 出　　处：《World Journal of Gastroenterology》索引2019年第25卷第36期,共15页高影响力期刊 摘　　要：BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC. 关 键 词：GAMMA-GLUTAMYLTRANSFERASE Aspartate aminotransferase PROTEIN induced by vitamin K ABSENCE or ANTAGONIST II ALPHA-FETOPROTEIN Hepatitis B virus Hepatocellular carcinoma
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