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注重肝癌诊断模式研究——肝纤维化诊断模式带来的启发和思考
高春芳,吴孟超
0
(第二军医大学东方肝胆外科医院,上海 200438)
摘要:
原发性肝细胞癌(HCC)的早期诊断目前仍然是临床一大难题,以甲胎蛋白(AFP)为代表的肿瘤标志物及多种肝脏酶学、细胞因子、糖蛋白等的检测对HCC诊断具有一定价值, 但实际应用中存在敏感性、特异性不高等诸多问题。多种肝纤维化(硬化)实验诊断模型的成功建立和运用提示,大样本临床研究是建立多参数数学诊断模型的前提条件,所建立的模型在临床大样本及随访病例中经过验证,具有较高的敏感性、特异性及可行性。因此,在HCC实验诊断中,建议重视合理、综合利用现有的多种实验室指标,这样既能提高早期诊断率,又能有效节约有限的医疗资源,是现阶段切实可行的提高原发性HCC诊断的有效手段。
关键词:  癌,肝细胞  诊断  敏感性;特异性
DOI:10.3724/SP.J.1008.2007.01277
投稿时间:2007-09-24修订日期:2007-10-18
基金项目:国家自然科学基金(30770994,30571774); 上海市科学委员会登山计划(064119522).
More attention to be paid on diagnostic models of hepatocellular carcinoma: hint from liver fibrosis diagnostic models
GAO Chun-fang,WU Meng-chao
(Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438,China)
Abstract:
Early diagnosis of hepatocellular carcinoma (HCC) is still a great challenge in clinical practice. Tumor markers such as alpha-fetoprotein(AFP), liver enzymes, cytokines, and some special glycoproteins, though helpful, are not sensitive and specific enough for early diagnosis of HCC. The establishment of several interesting predictive diagnostic models on liver fibrosis/cirrhosis suggests that mathematic predictive model, which is developed based on large sample size and follow-up study, might be of higher sensitivity, specificity and feasibility in clinical application. Here we suggest that more attention should be paid to this kind of multi-parameter predictive diagnostic models clinically, so as to improve the early diagnosis of HCC in a more economical and feasible way.
Key words:  carcinoma,hepatocellular  diagnosis  sensitivity  specificity