α-L-岩藻糖苷酶、血清铁蛋白及转化生长因子α对甲胎蛋白低表达肝癌的诊断价值

Diagnostic value of AFU, TGF-α and Fer in the AFP lowly expression primary hepatic carcinoma

目的探讨肿瘤标志物α—L-岩藻糖苷酶（AFU）、血清铁蛋白（Fer）及转化生长因子α（TGF—α）在诊断甲胎蛋白（AFP）低表达肝癌中的临床价值。方法应用全自动生化免疫模块分析仪，测定56例AFP阴性及低浓度表达的原发性肝癌患者和36例良性肝病患者血清的AFU、Fer含量，用ELISA法测定TGF—α含量。用ROC曲线评价三项指标诊断AFP低表达肝癌的敏感性和特异性。结果AFU、Fer、TGF—α血清含量在肝癌组和良性肝病组间差异有统计学意义（P〈0．05）；ROC曲线下的面积从大到小依次为AFU（0．707）〉TGF-α（0．677）〉Fer（0．592）；Fer诊断AFP低表达肝癌的敏感性较低，AFU和TGF-α相比较，在诊断敏感性相同（64％）的情况下，AFU诊断特异性（64％）高于TGF-α的诊断特异性（61％）。结论AFU诊断AFP阴性及低浓度表达肝癌的临床价值优于TGF—α和Fer；对诊断AFP低表达肝癌有一定的准确性。

Objective To study the diagnostic value of serum α-L-fucosidase （AFU）, transforming growth factor alpha（ TGF-α）and ferritin （Fer） in primary hepatic carcinoma （PHC）. Methods AFU and Fer in the serum were studied in 36 patients with benign hepafism and 56 patients with low concentration AFP of PHC hepatic carcinoma by automatic biochemistry analyzer Roche Modular. ELISA was used to assay the degree of TGF-α. The sensitivity and specificity of AFU, TGF-α and Fer for low expression AFP of PHC were evaluated by ROC curve. Results The serum AFU, Fer and TGF-α levels were all significant difference in the patients than those in controls （P 〈0.05）. The area under ROC curve of these indexes in descending order was AFU （0.707）, TGF-α （0.677） and Fer （0.592）. The diagnostic sensitivity of Fer was lower than AFU and TGF-α in diagnosis of AFP lowly expression PHC. The ratio showed AFU better than TGF-α. The diagnostic specificity of AFU （64 %） was higher than that of TGF-α （61%） when TGF-α and AFU was at the same diagnostic sensitivity （64 %）. Conclusion AFU is more valuable than Fer and TGF-α for negative or AFP lowly expression PHC, meanwhile it has much more accuracy.