新型肿瘤标志物(PIVKAII) 临床应用进展及评价.pptVIP

Early HCC diagnosis: DCP 0.84 (95% CI 0.81-0.87) AFP 0.68 (95% CI 0.64-0.72) combine AFP+DCP 0.83 (95% CI 0.79-0.86) SMMC 7721 HepG2 外源性DCP促进肝癌细胞的生长，且存在量效关系 HepG2 SMMC7721 A: VEGF B: TGFα C: FGF EGFR VEGF 本实验室数据 大样本 临床case-control 验证 HCC 313 胆管癌 83 转移性肝癌 29 肝血管瘤 31 肝硬化 75 健康对照 194 合计 725 非HCC 阳性 阴性 阳性率(%) 合计 肝硬化 21 54 28 75 肝血管瘤 0 31 0 31 继发性肝癌 3 26 10.34 29 胆系肿瘤 30 53 36.14 83 健康人群 6 188 1.54 194 合计 60 352 17.04 412 DCP 阳性 阴性 阳性率(%) 合计 HCC 255 58 81.46 313 非HCC 60 352 17.04 412 合计 315 410 725 DCP 总体阳性分布情况 The Sensitivity and Specificity of AFP, DCP, and DCP AFP Marker Cutoff Sensitivity Specificity YI DCP 40 81.0% 85.9% 0.669 (mAU/mL) 46.5 80.2% 87.9% 0.681 AFP 20 88.4% 78.1% 0.665 (ng/mL) 7 80.5% 87.1% 0.676 DCP+AFP 40+20 OR 97.8% 67.1% 0.649 AND 71.6% 96.9% 0.685 AFPDCP ROC Area Under the Curve Test Result Variable(s) Area Std. Errora Asymptotic Sig.b Asymptotic 95% Confidence Interval Lower Bound Upper Bound AFP .886 .013 .000 .861 .912 DCP .868 .015 .000 .840 .897 The test result variable(s): AFP, DCP has at least one tie between the positive actual state group and the negative actual state group. Statistics may be biased. a. Under the nonparametric assumption b. Null hypothesis: true area = 0.5 AUC Cutoff Sensitivity Specificity 95%CI AFP DCP 0.886 0.868 6.9 46.5 80.8% 80.2% 87.4% 87.9% 0.861-0.912 0.840-0.897 AFP DCP HCC Non-HCC 小计 HCC 182 133 315 Non-HCC 50 360 410 小计 232 493 725 DCP 与AFP 诊断效率一致性比较 Kappa 值： 0.47 Intra-assay and inter-assay CV Intra-assay Mean±SD CV (%) inter-assay Mean±SD CV (%) L M H 47.33±1.15 553.33