新微量离心柱法检测甲胎蛋白异质体对肝癌诊断的研究

Subject diagnostic value of detecting alpha-fetoprotein variants with a new microspincolumn method in hepatocellular carcinoma

目的 探讨采用新型微量离心柱法检测甲胎蛋白异质体AFP-L3在良恶性肝病及肝癌预警中的作用。方法 应用装有耦联了小扁豆凝集素（LCA）的微量离心柱分离甲胎蛋白异质体，采用化学发光法检测AFP和AFP-L3，并计算AFP-L3在AFP中的含量比例[AFP-L3（％）]，分析AFP-L3（％）升高者与良恶性肝病的关系。结果 肝细胞癌患者血清中AFP-L3（％）明显高于其他肝病患者，P值均〈0．001，以AFP-L3（％）≥10作为诊断指标，在已经确诊为肝癌的患者中灵敏度是90．9％。结论 微量离心柱法检测甲胎蛋白异质体AFP-L3在预警肝细胞癌诊断及鉴别诊断中具有重要临床价值，特别是对低甲胎蛋白含量的肝病鉴别具有重要临床价值。

Objective To evaluate the usefulness of new microspincolumn method for the measurement of alpha-fetoprotein variant AFP-L3 in differentiation of benign and malignant liver disease and the warming for liver cancer. Methods AFP-L3 was isolated by using microspincolumn coupled with lens culinaris agglutinin （LCA）, AFP and AFP-L3 were determined with chemiluminescent immunoassay, the proportion of AFP-L3 levels [ AFP-L3 （%） ] were calculated, and the relationship between the elevated AFP-L3（ % ） levels and benign and malignant liver disease was analyzed. Results The levels of AFP-L3 （ % ） in serum of patients with hepatocellular carcinoma was significantly hingher than those in the patients with other liver diseases（ P 〈 0.001 ）. Taking AFP-L3（ % ） 10% as the diagnostic triteria, the sensitivity for diagnosis of liver cancer was 90.9%. Conclusion Detection of AFP-L3 seemed to be of clinical value in diagnosis and differential diagnosis of bepatocellular carcinoma; it may be especially important for identifying patients with hepatocellular carcinoma whose alpha-fetoprotein level is low.