AFP—IgM复合物联合AFP对诊断肝癌的互补作用

Complementary Effect between AFP and AFP-IgM in the Process of Hepatocellular Carcinoma Diagnosis

目的探讨新型肿瘤标志物AFP—IgM免疫复合物和甲胎蛋白（AFP）对肝细胞肝癌（Hepatocellular carcinoma，HCC）诊断的互补作用。方法用酶联免疫吸附法与电化学发光法同步检测113名正常人、85例HCC患者、23例肝硬化和63例肝炎患者血清AFP—IgM与AFP含量。应用ROC曲线确立AFP—IgM和AFP的最佳切割值分别为300AU／m1和20μg／L作为有诊断学意义的临界值。在此切割值下，对AFP诊断为阴性的患者血清进行AFP—IgM检测以及对AFP—IgM诊断为阴性的患者血清进行AFP检测，探讨两种诊断方法对HCC诊断的互补作用。结果在AFP诊断为阴性的HCC患者中AFP—IgM诊断的敏感度为68．0％，特异度为83．6％，有效率为81．6％；在AFP—IgM诊断阴性的HCC患者中AFP诊断的敏感度为74．2％，特异度为91．7％，有效率为88．8％。结论AFP与AFP-IgM联合检测将提高对HCC诊断的效率，AFP和AFP—IgM在HCC的诊断中具有较好的互补性。

Objective To study the complementary effect between the new tumor marker alpha fetoprotein immunoglobulin M complex（AFP-IgM） and alpha fetoprotein（AFP） in the process of hepatocellular carcinoma diagnosis. Methods The AFP and AFP-IgM serum level of 113 health subjects, 85 patients with hepatocellular carcinoma, 23 patients with cirrhosis and 63 patients with hepatitis were detected by the enzyme linked immunosorbent assay（ELISA） and electro-chemiluminescence. The best cut-off value of AFP and AFP-IgM were determined by the ROC curve,which was 20 μg/L and 300 AU/ml respectively. Under this cut-off value,to detect the serum level of AFP-IgM in AFP diagnosed negative group and the serum level of AFP in AFP-IgM diagnosed negative group could greatly improve the efficacy in the process of hepatocellular carcinoma diagnosis,and approach the complementary effect of the two tumor markers. Results The sensitivity, specificity and availability of AFP-IgM were 68.0%, 83.6% and 81.6% respectively in AFP diagnosed negative group,the sensitivity,specificity and availability of AFP were 74. 20%, 91.7% and 88. 8% respectively in AFP-IgM diag-nosed negative group. Conclusion It suggested that there was a good complementary effect between AFP and AFP-IgM in the praocess of hepatocellular carcinoma diagnosis.