新微量离心柱法测定甲胎蛋白异质体对原发性肝癌诊断的价值(附297例分析)

The diagnostic value of detecting alpha-fetoprotein variants with a new microspincolum method in primary liver cancer:Analysis of 297 cases

目的探讨新微量离心柱法测定甲胎蛋白异质体(AFP-L3)在良性肝病及原发性肝癌预警中的作用。方法以装有耦联小扁豆凝集素(LCA)的微量离心柱分离慢性肝炎组、肝硬化组、原发性肝癌组共297例的患者血清甲胎蛋白异质体,用罗氏E170电化学发光免疫分析仪检测分离前AFP和分离后AFP(AFP-L3),计算AFP-L3在AFP中的含量比例[AFP-L3(%)]。结果原发性肝癌组AFP-L3(%)均值、阳性率与慢性肝炎、肝硬化组相比均显著增加(P<0.001),AFP低浓度(AFP<200μg/L)原发性肝癌组AFP-L3(%)与慢性肝炎、肝硬化组相比也显著增加(P<0.001);而在原发性肝癌组中,不同AFP浓度组的AFP-L3(%)均值与阳性率相比,差异无统计学意义(P>0.05)。结论新微量离心柱法测定AFP-L3(%)对肝癌和良性肝病的诊断具有重要意义,尤其对低浓度原发性肝癌和良性肝病的鉴别诊断具有重要的临床价值。

Objective To evaluate the usefulness of new microspincolum method for the measurement of alpha-fetoprotein variant （AFP-L3） in early warming for benign liver disease and primary liver cancer. Methods The microspincolum coupled with lens culinaris agglutinin （LCA） was used to isolate the AFP-L3 from the serums of 297 patients with chronic hepatitis, cirrhosis of liver and primary liver cancer. AFP and AFP-L3 were determined by Roche Modular E170 Automatic Electrochemiluminescence Immunoassay Analyzer, and the proportion of AFP-L3 levels EAFP-L3 （%） ] were calculated. Results The positive rate and the mean level of AFP-L3 either in the patients with primary liver cancer or in the patients with primary Iiver cancer whose AFP （〈200μg/L） were statistic significantly different from the patients with chronic hepatitis or cirrhosis of liver （P〈0. 001）. However, in the groups of primary liver cancer, there was no significant difference of the serum mean level and the positive rate of AFP-L3 among the groups of different AFP concentration （P〉0.05）. Conclusion The new microspincolum method detecting AFP-L3 shows important clinical value in the diagnosis of primary liver cancer; and it may be especially important for the differential diagnosis between the patients with primary liver cancer whose AFP level is low and the patients with benign liver disease.