甲胎蛋白异质体AFP—L3鉴别良恶肝病及预警肝癌的研究

The study on alpha - fetoprotein variant AFP - L3 differentiating benign and malignant liver diseases and the warning of hepatocellular carcinoma

目的研究微量离心柱法检测甲胎蛋白异质体（AFP—L3）用于鉴别良恶性肝病及对肝细胞癌的预警。方法147例AFP升高（主要为低浓度阳性）的肝病患者血清，同时检测AFP-L3％含量，对AFP—L3%异常升高者、正常者进行临床病理核对，分析AFP—L3%升高作为鉴别良恶性肝病的新指标是否比单纯检测AFP更为准确有效；并对疑似HCC的19例肝病患者结合6个月后临床诊断结果，分析AFP-L3％〉10％对肝癌的预警作用。结果AFP升高的患者中AFP—L3％值与AFP值无相关性；AFP—L3％〉10％对肝癌诊断敏感度为89．1％；诊断特异度为94．4％；总有效率为90．6％。AFP—L3〉10％发生肝癌的危险性比AFP—L3％〈10％增加了6．88倍。结论以AFP-1．3％〉10%做为诊断标准对区分良恶肝病具有良好的临床意义；AFP—13％〉10％可以做为肝细胞癌的预警。

Objective To evaluate the usefulness of microspineolumn method for the measurement of alphafetoprotein variant AFP- 13 in differentiation of benign and malignant liver diseases and the warning for hepatocellular carcinoma（ HCC）. Method 147 eases（low concentration） with elevated AFP liver diseases were included in this research. AFP - 13 were measured for these patients. The relation between AFP - 13 and hepatocellular carcinoma was analyzed according to clinical follow - ups and pathologies. Results There were no significant correlation between the values of AFP and AFP - L3. The relation between the AFP - L3 and HCC was significant. Taking AFP - L3 〉 10% as the diagnostic criterion, the sensitivity was 89.1%, and the specificity was 94.4%. The general effective rate was 90.6%. The risk of HCC was 6.88 time higher in patients with AFP - L3 〉 10% than that in patients with AFP - L3 〈 10%. Conclusion AFP - L3 〉 10% was clinically significant for the differentiation of benign and malignant liver diseases. And it was a good warning index for HCC.