AFP、AFP-L_3和AFU联合检测在原发性肝癌诊断中的应用

A study on the combined detection of AFP, AFP-L_3 and AFU in the diagnosis of primary hepatic cancer

目的:探讨3种血清肿瘤标志物甲胎蛋白(AFP)、AFP异质体(AFP-L3)和α-L-岩藻糖苷酶(AFU)联合检测对原发性肝癌(PHC)的互补诊断价值及对肝癌早期诊断的意义.方法:对我院2003年7月～2004年3月收治的49例PHC、50例慢性乙型肝炎和20例正常对照联合检测AFP、AFP-L3和AFU水平,采用电化学发光法测定AFP和AFP-L3水平,采用速率法测定AFU水平.结果:PHC组与慢性乙型肝炎组、正常对照组血清AFP水平相比差异有统计学意义(P<0.01);PHC组与慢性乙型肝炎组和正常对照组的AFP均数相比差异有统计学意义;3项标志物单项检测的敏感性分别为65.3%、85.7%、49.0%;联合检测AFP和AFP-L3或AFU可使检出率提高至92.1%和83.2%;3项指标联合检测PHC的检出率高达97.0%.结论:联合检测AFP、APF-L3和AFU 3项指标可提高HPC尤其是AFP阴性HPC的诊断效率,对HPC的早期诊断有一定的指导意义.

Objective: To study the complementary value of alpha fetoprotein (AFP), alpha fetoprotein variant and α L fucosidase to the diagnosis of primary hepatic cancer. Methods: Serum AFP, alpha fetoprotein variant and α L fucosidase were measured in 49 cases with primary hepatic cancer and 50 cases with chronic hepatitis B and 20 normal cases. The three indices were compared and analyzed for the their complementary diagnostic values to primary hepatic cancer. Results: The diagnostic sensitivities of AFP, alpha fetoprotein variant and α L fucosidase to primary hepatic cancer were 65.3%、85.7%、49.0% respectively. Simultaneous determination of AFP and alpha fetoprotein variant or α L fucosidase could increase the sensitivities to 92.1% and 83.2% respectively. Furthermore, combines detection of these three indices could make the diagnostic sensitivity as high as 97.0%. Conclusion: The combined assay of serum tumor markers is valuable in the diagnosis of primary hepatic cancer, especially in AFP negative patients.