微量离心柱法与亲和交叉免疫电泳法检测甲胎蛋白异质体的研究

Clinical research of AFP variant with microcentrifugalcolumn method and crossed affinity immunoelectrophoresis autoradiography method

目的比较微量离心柱法和亲和交叉免疫电泳自显影法两种方法检测甲胎蛋白异质体（AFP-L3）对甲胎蛋白阳性的良恶性肝病鉴别诊断价值。方法采用微量离心柱法和亲和交叉免疫电泳自显影法分别分析102例原发性肝癌、41例慢肝及肝硬化血清中的AFP-L3比率，比较2种方法检测AFP-L3％对良恶性肝病鉴别诊断价值。结果微量离心柱法和亲和电泳法对102例原发性肝癌AFP-L3％的敏感性分别是79．4％、91．2％。对41例慢肝、肝硬化AFP-L3％的特异性分别为70．7％、29．3％。亲和电泳法、微量离心柱法两种方法检测肝癌的符合率分别为76．9％、73．4％，在ROC曲线下的面积AUC分别为0．791、0．758。4例AFP低值的原发性肝癌，采用亲和电泳方法检测均为阴性，而采用微量离心柱方法检测均为阳性。结论微量离心柱法检测AFP-L3不仅操作简便、省时，而且比传统亲和电泳方法更适合于AFP阳性良恶性肝病的鉴别诊断。

Objective To compare the clinical alue of microcentrifugalcolumn method with crossed affinity immunoelectrophoresis autoradiography method for the measurement of alpha-fetoprotein variant （AFP-L3） in differentiation of benign and malignant liver. Methods Serum AFP-L3 variants in 102 primary hepatocellular carcinoma patients and 41 chronic and cirrhosis patients were separated by microcentrifugalcolumn method and crossed affinity immunoelectrophoresis autoradiography method and the clinical value of both method were compared. Results In 102 primary hepatocellular carcinoma patients, the sensitivity of AFP-L3 was 79.4% and 91.2% respectively, in 41 chronic and cirrhosis patients. The specificity of AFP-L3 was 70.7% and 29.3% respectively. The diagnostic accuracy was.76.9% and 73.4% respectively. The area in the ROC curve was 0.791and 0.758 respectively. In the 4 primary hepatocellular carcinoma patients with lower AFP-L3, the AFP-L3 was positive by useing microcentrifugalcolumn method, but none of AFP-L3 were found by useing crossed affinity immunoelectrophoresis autoradiography method. Conclusion The micro centrifugalcolumn method is more simple and rapid, it may be more useful in differentiation of benign and malignant liver than traditional crossed affinity immunoelectrophoresis autoradiography method.