丙氨酸转氨酶水平对甲胎蛋白预测乙型肝炎感染肝细胞癌的

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Influence of Alanine Transaminase Levels on Alpha-Fetoprotein for Predicting Hepatocellular Carcinoma in Patients with Hepatitis B Infection
Jiahao Chen  1 , Manli Wu  2 , Jiao Gong  1 , Zhihuan Liu  1 , Guowei He  1 , Huiqing Zhu  3 , Zhaoxia Li  1 , Bo Hu  1
Affiliations
Affiliations

    1
    Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    2
    Department of Ultrasound, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    3
    School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, China.

    PMID: 33490235 PMCID: PMC7787738 DOI: 10.1155/2020/2043715

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Abstract

Purpose: To investigate the influence of alanine transaminase (ALT) on the accuracy of alpha-fetoprotein (AFP) for detecting hepatocellular carcinoma (HCC).

Methods: This retrospective study recruited 799 patients with HCC, cirrhosis, and chronic hepatitis due to hepatitis B infection and healthy adults between July 2017 and January 2019. Comparisons of the area under the receiver operating characteristic curves (AUCs) for detecting HCC in different ALT levels were calculated.

Results: Serum ALT and gamma-glutamyl transferase levels were significantly associated with elevated AFP in patients without HCC. The AUC of AFP was higher in patients with ALT ≤ 2 upper limit of normal (ULN) than in patients with ALT > 2 ULN (0.806 vs. 0.611, P < 0.001). Nevertheless, there were no significant differences in the AUCs of AFP/(ALT × aspartate aminotransferase (AST)) in patients with ALT ≤ 2 ULN and with ALT > 2 ULN (0.745 vs. 0.769, P = 0.68). AFP/(ALT × AST) was better than AFP in patients with ALT > 2 ULN for detecting HCC (P < 0.001).

Conclusions: Higher ALT levels might impair the accuracy of AFP for diagnosing HCC. AFP tests showed better accuracy in patients with ALT ≤ 2 ULN whereas the AFP/(ALT × AST) ratio was recommended in patients with elevated ALT levels.

Copyright © 2020 Jiahao Chen et al.

StephenW

丙氨酸转氨酶水平对甲胎蛋白预测乙型肝炎感染肝细胞癌的影响
陈嘉豪1，吴曼丽2，脚弓1，刘志欢1，何国伟1，朱慧清3，李兆霞1，胡波1
隶属关系
隶属关系

    1个
    中山大学附属第三医院检验医学科，广州
    2
    中山大学附属第三医院超声科，广州
    3
    广东药科大学临床医学院，广州。

    PMID：33490235 PMCID：PMC7787738 DOI：10.1155 / 2020/2043715

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抽象

目的：研究丙氨酸转氨酶（ALT）对甲胎蛋白（AFP）检测肝细胞癌（HCC）准确性的影响。

方法：这项回顾性研究招募了799例2017年7月至2019年1月之间由乙型肝炎感染引起的HCC，肝硬化和慢性肝炎的患者以及健康成人。比较接受者工作特征曲线（AUC）下用于检测不同ALT中HCC的面积的比较计算水平。

结果：无肝癌患者的血清ALT和γ-谷氨酰转移酶水平与AFP升高显着相关。 ALT≤2正常上限（ULN）的患者的AFP AUC高于ALT> 2 ULN的患者（0.806 vs. 0.611，P <0.001）。尽管如此，ALT≤2 ULN和ALT> 2 ULN的患者的AFP /（ALT×天冬氨酸转氨酶（AST））的AUC没有显着差异（0.745 vs. 0.769，P = 0.68）。对于检测HCC的ALT> 2 ULN的患者，AFP /（ALT×AST）优于AFP（P <0.001）。

结论：较高的ALT水平可能会损害AFP诊断HCC的准确性。 AFP测试显示ALT≤2 ULN的患者准确性更高，而ALT水平升高的患者建议AFP /（ALT×AST）比。

版权所有©2020 Jiahao Chen等。

StephenW

https://www.hindawi.com/journals/bmri/2020/2043715/