PIVKA-II、AFP、RPR联合应用在乙肝病毒相关性肝细胞癌中的早期诊断价值

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【关键词】肝细胞癌;乙肝病毒；甲胎蛋白;异常凝血酶原;早期诊断；红细胞分布宽度与血小板比值中图分类号：R735.7 文献标志码：A DOI：10.3969/j.issn.1003-1383.2025.12.004

【Abstract】ObjectiveTo explore the valueof thecombinedapplicationof abnormal prothrombin（PIVKA-I），alphafetoprotein（AFP），andredbloodcelldistribution width-to-plateletratio（RPR）intheearlydiagnosisof hepatitisB virusrelatedhepatocellarcarcinoma（HBV-HCC）.MethodsAtotalof 45HBV-HCC patients（allwereTNMI-II）admitted tothePeople'sHospitalof Guigang CityfromJuly2O22 to March2O23 wereenroledascase group.Andthenormal control group（71 healthy people）and cirhosis control group（45 patients with hepatitis Bcirhosis）were selected ascontrols.The serumPIVKA-II，AFPlevels，andRPRvaluesofthe thre groups were measured.Thediagnostic eficacyofdierent indicatorsalone and incombination for HBV-HCC werecompared.Therelationshipsamong indicators andthe diagnostic advantagesof theircombined applicationwere further analyzedbyrelevant diagrams.ResultsThe PIVKA-IandAFPlevels，as wellas theRPRvalues，weresignificantlyhigherinthecasegroupthaninthenormalcontrol groupandcirrhosiscontrol group，and the RPR value was higher than the normal control group but lower than the cirhosis control group（ P<0.05 ）. The sensitivity ofPIVKA-II，AFP，and RPR for detecting HBV-HCC separately were93. 3% ，93. 3% ，and 80.0%， respectively，and specificity was 98. 3% ， 96.6% ，and 56.9% ，respectively. The sensitivity of the combined detection increased to 97.8% and specificity was 100.0% . Based on column chart and calibration curve analysis，the combined diagnostic model demonstrated good predictiveperformanceandaccuracy.ConclusionThecombined aplication of PIVKA-II， AFP，and RPR can improve the sensitivity of early HBV-HCC diagnosis and holds significant clinical value.

【Keywords】hepatocelular carcinoma（HCC）; hepatitis B virus;alpha-fetoprotein（AFP）；PIVKA-II；early diagnosis;red blood cell distribution width-to-platelet ratio（RPR）

肝细胞癌（hepatocellularcarcinoma，HCC）是全球癌症相关死亡的第三大原因，乙型肝炎病毒（hep-atitisBvirus，HBV）感染为主要诱因，尤其在亚洲地区[1-3]。（剩余13771字）