异常凝血酶原预测肝癌微血管侵犯的价值研究
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i5.10093
Abstract
目的：探讨肝细胞癌(hepatocellularcarcinoma,HCC)发生微血管侵犯(MVI)的影响因素及研究血清异常凝血酶原(PIVKA-II)预测HCC发生MVI的价值；方法 回顾性分析湖南省人民医院2020-01-01至2024-03-31行手术治疗且病理结果为HCC的126例患者的临床资料。按照是否发生MVI分为MVI阴性组(60例)和MVI阳性组(66例)。收集患者基本信息及术前的病理、影像学、PIVKA-Ⅱ、甲胎蛋白、血常规、肝功能、凝血功能等指标,采用单因素及多因素Logistic回归探讨HCC出现MVI的影响因素,且根据受试者工作曲线(ROC)研究PIVKA-Ⅱ预测HCC发生MVI的价值。结果 (1)通过单因素分析发现：白细胞、凝血酶原时间、血小板、总胆红素、甲胎蛋白、异常凝血酶原、肿瘤最大径、肿瘤个数差异具有统计学意义(P<0.05)；(2)多因素Logistic回归分析发现：PIVKA-II(OR=2.001,P=0.007)为HCC患者发生MVI的独立危险因素；(3)ROC曲线分析发现：PIVKA-Ⅱ诊断MVI的曲线下面积(AUC)、灵敏度、特异度和截断值分别为0.935、86%、87%、270.15mAU/ml。结论(1)PIVKA-II大于270.15mAU/ml是HCC出现MVI的独立危险因素。(2)PIVKA-II预测HCC出现MVI有良好的价值。
Keywords
异常凝血酶原；肝细胞癌；微血管侵犯
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