甲胎蛋白异质体AFP-L3测定的临床意义

Clinical significance of serum lens culinaris agglutinin reactive alpha-fetoprotein

目的探讨甲胎蛋白异质体ＡＦＰ－Ｌ３检测的临床意义。方法采用扁豆凝集素亲和交叉免疫电泳自显影法，将血清甲胎蛋白（ＡＦＰ）分为ＡＦＰ－Ｌ１，ＡＦＰ－Ｌ２，ＡＦＰ－Ｌ３３条电泳带。结果肝细胞癌（ＨＣＣ）患者的ＡＦＰ－Ｌ３阳性率为５９．６％，显著高于肝硬化（５．４％）等良性肝病组。其中ＡＦＰ－Ｌ３阳性的２例肝硬化患者均在以后观察阶段被诊断为ＨＣＣ，且ＡＦＰ－Ｌ３显示阳性，提示肝癌的存在和发生，先于Ｂ超、ＣＴ等影像学手段。直径为２ｃｍ以下的单发性小肝癌的ＡＦＰ－Ｌ３阳性率为２７．３％，ＡＦＰ－Ｌ３与ＡＦＰ值无相关性。结论ＡＦＰ－Ｌ３的测定对于ＡＦＰ阳性时的良、恶性肝病的鉴别及肝癌的早期诊断具有重要意义。

Objective To evaluate the clinical significance of serum alpha-fetoprotein variants (AFP-L3).Method Serum alpha-fetoprotein variants were divided into three electrophoresis strips as AFP-L1,AFP-L2,AFP-L3 using lenticular agglutinin cross with artibody-affinity immunoelectrophoresis blotting.Results AFP-L3 was detected in 59.6% of the patients with hepatocellular carcinoma (HCC),5.4% of the patients with liver cirrhosis (LC) and none of the patients with chronic hepatitis.Two cases with positive AFP-L3 developed HCC during the follow-up period.27.3% of the patients with a solitary small HCC (less than 2 cm in diameter) were positive for AFP-L3.There is no significant correlation between percentages of AFP-L3 and serum concentration of AFP Conclusion AFP-L3 is very useful in the early diagnosis of small HCC and the prediction of HCC development.