离心管法甲胎蛋白异质体检测的临床应用探讨

Study on clinical application of lectin-reactive alpha-fetoprotein

目的:探讨离心管法分离甲胎蛋白异质体AFP-L3对鉴别肝癌、肝硬化、慢性肝炎的诊断价值。方法:采用微量离心法分离AFP-L3,然后再采用化学发光的方法检测AFP、AFP-L3,并计算AFP-L3%。结果:以AFP-L3%>10%作为阳性的判断标准,肝癌组敏感性为92.8%,特异性为95.0%,AFP-L3含量与血清AFP浓度及原发性肝癌病灶大小无关。结论:AFP-L3结合AFP检测对肝癌,尤其是小肝癌(<2 cm)的早期诊断和肝硬化及良性肝病的鉴别诊断具有重要的临床应用价值,并不受肝癌诊断标准AFP>400 ng/ml的限制。

Objective：To investigate the diagnostic value of lectin-reactive alpha-fetoprotein（AFP） in the patients of liver cancer,liver cirrhosis and chronic hepatitis.Methods：Chemiluminescence assay was applied to measure the serum AFP and AFP-L3 levels.Results：The ratio of AFP-L3 to AFP 10% was set as positive criteria.The sensitivity and specificity of liver cancer group were 92.8% and 95.0%,respectively.No relationship was found between the serum level of AFP-L3 or AFP and primary liver cancer lesion size.Conclusion：AFP-L3 combined with AFP detection has important clinical value in early-diagnosis for liver cancer,particularly small liver cancer（2 cm） and differential diagnosis of benign liver disease and cirrhosis.It is not subject to liver cancer diagnostic criteria（AFP400 ng/ml） restrictions.