腹部超声、CT联合血清甲胎蛋白诊断原发性肝癌的临床价值

目的:研究腹部超声、CT联合血清甲胎蛋白（AFP）诊断原发性肝癌的价值。方法:回顾性分析我院于2017年1月至2018年1月期间收治的50例确诊原发性肝癌患者作为肝癌组，另选取同期收治的50例肝脏良性肿瘤患者作为良性组及50例来院参加健康体检的志愿者作为对照组。以病理结果为标准，对比三组受检者的腹部超声、CT诊断阳性率，血清AFP水平，联合诊断的敏感度、特异度、阳性预测值及阴性预测值，并研究联合诊断不同分期原发性肝癌的阳性率。结果:三组受检者对比，肝癌组患者的腹部超声、CT诊断阳性率及AFP水平均高于良性组及对照组，且良性组高于对照组，差异均有统计学意义(P＜0.05)。腹部超声、CT及AFP联合诊断Ⅰ-Ⅱ期及Ⅲ-Ⅳ期肝癌的阳性率高于单项诊断，差异均有统计学意义(P＜0.05)。诊断效能对比，腹部超声、CT及AFP联合诊断的特异度、敏感度、阴性预测值及阳性预测值均高于单项诊断，差异均有统计学意义(P＜0.05)。结论:腹部超声、CT联合血清AFP诊断原发性肝癌，较各单项诊断阳性率高，且联合诊断的敏感性及特异性更好，可有效明确肝癌分期，值得在临床上推广。

Clinical value of abdominal ultrasound,CT combined with alpha fetoprotein in the diagnosis of primary liver cancer

Objective:To study the value of abdominal ultrasonography,CT combined with serum alpha fetoprotein(AFP) in the diagnosis of primary liver cancer(HCC).Methods:50 cases of patients were retrospectively analyzed in our hospital in January 2017-January 2018 in primary hepatocellular carcinoma as hepatocellular carcinoma group,50 cases of benign liver tumors were selected from patients as benign group and 50 patients to the hospital to participate in healthy volunteers as control group.The three groups were treated with abdominal ultrasound,CT combined with serum alpha fetoprotein.Based on pathological results,we compared the abdominal ultrasound and CT diagnostic rate,serum AFP level,sensitivity,specificity,positive predictive value and negative predictive value of three groups of patients,and studied the positive rate of combined diagnosis of primary liver cancer at different stages.Results:The abdominal ultrasound,CT diagnosis rate and AFP level in the HCC group were higher than those in the benign group and the control group,and the benign group was higher than that in the control group,the difference was statistically significant(P＜0.05).The specificity,sensitivity,negative predictive value and positive predictive value of abdominal ultrasound,CT and AFP combined diagnosis were all higher than those of single diagnosis,and the difference was statistically significant(P＜0.05).The positive rate of abdominal ultrasound,CT and AFP in the diagnosis of stage I-Ⅱ and stage Ⅲ-Ⅳ was higher than that of single diagnosis,and the difference was statistically significant(P＜0.05).Conclusion:Abdominal ultrasonography and CT combined with serum AFP in the diagnosis of primary liver cancer have high positive rates of single diagnosis,and the sensitivity and specificity of combined diagnosis is better,which can effectively clarify the stage of liver cancer,and is worthy of clinical promotion.