低浓度甲种胎儿球蛋白检测对肝癌早期诊断的价值

Low positive AFP for the diagnosis of hepatocellular carcinoma

目的探讨在有肝实质占位病变时甲种胎儿球蛋白(AFP)低浓度阳性对肝细胞癌早期诊断的价值。方法收集1999年1月至2006年10月我院共收治肝癌患者577例,对其中401例患者测定的AFP水平进行分析。结果我们对通过AFP低浓度升高结合影像学检查发现的早期小肝癌进行手术,大大提高了治疗效果.降低了医疗费用,改善预后。结论(1)在有肝实质占位病变存在时,AFP低浓度升高也有重要诊断意义,并不需要等待AFP>200μg/L或400μg/L才能诊断肝细胞癌。(2)提出甲种胎儿球蛋白低浓度肝细胞癌的概念有利于在AFP较低浓度时作出肝细胞癌的早期诊断。(3)用AFP>20μg/L结合B型超声、CT等联合诊断,提高了单一诊断手段的敏感性和特异性。

Objective To investigate the value of low positive AFP level for the diagnosis of hepatocellular careinoma（HCC） when a space occuping lesion was already identified in the liver. Methods The AFP level of 401 HCC cases from January 1999 to October 2006 were retrospectively analyzed. Results 22 cases of small liver cancer underwent reducing surgical resection in our hospital, increasing the quality of life and prolonging survival rate. Con- clusion （1）The AFP level between 20 and 200μg/L is of diagnostic for HCC when a ,SOL is identified. （2）The clinical reference diagnostic criteria using AFP level more than 20μg/L,instead of more than 200μg/L is helpful for the diagnosis. （3）Combined diagnosis of AFP level more than 20μg/L and ultrasonography or CT scanning yields higher sensitivity and specificity than traditional diagnostic criteria.