Objective:To investigate the diagnostic significance of combined detection of serum alpha-fetoprotein(AFP), neutrophil gelatinase-associated lipocalin(NGAL)and fibrinogen(Fbg)in primary liver cancer.Methods:A total of 92 patients with primary liver cancer(PLC) who were treated in our hospital from January 2016 to December 2017 were selected as the PLC group. In addition, 53 patients with hepatitis B(the HBV group), 46 patients with liver cirrhosis(the cirrhosis group) and 50 healthy persons(the health group) who were treated in our hospital during the same period were selected as study subjects. The serum AFP level and the serum NGAL level were detected by Roche E601 automatic analyzer and enzyme-linked immunosorbent assay(ELISA), respectively. The levels of serum AFP and NGAL in each group were compared. The serum Fbg levels in each group detected by using the SSTA-COMPACT automatic coagulometer were compared. The relationship between serum AFP, NGAL, Fbg and PLC clinical cases was analyzed. Pearson correlation analysis was used to analyze the correlation between serum AFP, Fbg and NGAL. The receiver operating characteristic curve(ROC) was used to determine the sensitivity and specificity of serum AFP, NGAL, Fbg detection and combined detection for diagnosis of PLC.Results:The serum levels of AFP, NGAL and Fbg in the PLC group were(683.27±416.54) ng·ml-1,(32.09±9.04) ng·ml-1 and(5.52±1.38) g·L-1, respectively, which were significantly higher than those in the HBV group, the cirrhosis group and the health group(P<0.05). The serum AFP in the HBV group was also significantly higher than that in the cirrhosis group and the health group(P<0.05), and there was no significant difference in other indicators(P>0.05). There was no significant difference in serum levels of AFP, NGAL and Fbg between the cirrhosis group and the health group(P>0.05). In the PLC group, the serum AFP, NGAL and Fbg levels increased significantly with the increase of patients' TNM stage. The serum AFP, NGAL and Fbg levels in patients with stage Ⅲ-Ⅳ were significantly higher than those in stage I-Ⅱ(P<0.05). The correlation analysis showed that there was no significant correlation between serum AFP, NGAL and Fbg in PLC patients(P>0.05). The ROC curve showed that the area under the curve(AUC) of serum AFP, NGAL, and Fbg was 0.851, 0.866 and 0.819, respectively. The sensitivity of combined detection of serum AFP, NGAL and Fbg increased to 95.3%. Conclusion:The serum AFP, NGAL and Fbg levels in PLC patients are significantly elevated and can be used as diagnostic tumor markers for PLC. Combined detection of these three factors can significantly increase the sensitivity of PLC diagnosis, which has an important clinical value in the diagnosis of PLC and evaluation of patient prognosis.
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