甲胎蛋白及甲胎蛋白异质体L3在肝癌患者肝移植手术前后的变化

The content change of AFP and AFP-L3 pre-and post-liver transplantation operation for liver cancer patients

目的 探讨甲胎蛋白（AFP）及甲胎蛋白异质体L3（AFP-L3）在肝癌患者肝移植手术前后的变化情况.方法 对12例确诊为肝癌并进行肝移植手术患者的连贯血清（术前1份,术后连续留取）,应用甲胎蛋白异质体微量离心柱分离并洗脱获得AFP-L3,再同时检测原始血清中AFP及AFP-L3含量,计算AFP-L3在AFP中比例（AFP-L3%）,对比手术前后AFP含量及AFP-L3%的变化情况.结果 AFP除5例转阴外,其余患者在AFP-L3%转阴后,AFP仍持续阳性,个别患者AFP含量还持续高水平.2例患者术后AFP-L3立即转阴,其他患者在肝移植术后AFP-L3含量逐步下降,并趋于阴性（AFP-L3%〈10%）.AFP半衰期与AFP-L3%半衰期之间差异无统计学意义.结论 肝癌经根治性切除或移植后,AFP-L3%一般在较短时间内（约1～20 d）转阴,AFP-L3占AFP百分含量占10%以下,提示手术可能较为彻底,但余肝尚存在肝炎或肝硬化.如AFP-L3含量持续不降低提示手术未彻底清除病灶.

Objective To explore the content change of Alpha Fetal Protein（AFP） and Alpha Fetal Protein Variants（AFP-L3） pre-and post-liver transplantation operation for liver cancer patients.Methods AFP-L3 was de-termined by micro centrifugal column from twelve cases of successive sera（For each case,one original shale pre-oper-ation,and mole shares post-operation successively）,and preserved from patients who were diagnosed as fiver cancer and completed fiver transplantation operation.simultaneously the content of AFP and AFP-L3 in the original serum were also determined.and the ratio of AFP-L3 in AFP was calculated in order to compare the content change of AFP and the ratio of AFP-L3 pre-and post-liver transplantation operation.Results Compared with twelve cases of pre-and post-operation,the AFP in only five cases turned tO negative;The AFP in other cases keeped positive though AFP-L3%tumde to negative.and the content of AFP in some specific cases still keeped in a high level.Regarding AFP-L3,besides two casses turning to negative immediately after operation,the content of AFP-L3 in other patients de-creased gradually after operation,and it approached to negative（AFP-L3%〈10%）.Through statistical analysis,be-tween the half lives of AFP and AFP-L3%,there waa no statistic significance.Therefore,AFP-L3% could be considered as an independent reference item.Conclusion After a radical cure of liver resection or liver transplantation operation,AFP-L3%usually turned to negative in a rather short period （about 1 to 20 days）.The ratio of AFP-L3 in AFP became be-low 10%,and it indicated that the operation would be quite complete,remaining liver would have hepatitis or hepatocirrho-sis.Otherwise,the ratio was not decrease during a long period,and it indicated the operation had not eliminated focuses completdy.