联合检测GPDA同工酶和AFP对原发性肝癌诊断价值的探讨

THE VALUE OF SIMULTANEOUS DETERMINATION OF SERUM GPDA ISOENZYME AND AFP TO THE DIAGNOSIS OF PRIMARY HEPATOCELLULAR CARCINOMA

目的 :研究联合检测血清甘氨酰脯氨酸二肽氨基肽酶 ( GPDA)同工酶和甲胎蛋白 ( AFP)对原发性肝癌的诊断价值。方法 :采用改良垂直平板阶段梯度聚丙烯酰胺凝胶电泳分离血清 GPDA同工酶 ,以放免法检测 AFP,对 10 2例原发性肝癌 ( PHC)、2 4例慢性肝炎、45例肝炎后肝硬化、2 0例转移性肝癌、3 5例良性肝占位性病变以及 80例正常人血清 GPDA同工酶和 AFP进行了同步检测。结果 :血清 GPDA可分离为 GPDA-F和 GPDA-S两条区带 ,正常人和良性肝占位性病变患者血清仅存在 GPDA-S,肝癌患者GPDA-F阳性率为 85 .3 % ,明显高于良性肝病 ( P<0 .0 0 1) ,GPDA-F和 AFP无相关性。结论 :GPDA-F为一新的肝癌血清标志物 ,有助于 AFP阴性肝癌的诊断。联合检测 GPDA-F和 AFP可提高对

Objective:To study the value of simultaneous determination of serum alpha-fetoprotein (AFP) and glycylproline dipeptidyl aminopeptidase (GPDA) isoenzymes to the diagnosis of primary hepatocellular carcinoma. Methods : GPDA isoenzymes were separated with a modified vertical slab stage gradient polyacrylamide gel electrophoresis. AFP was measured with radioimmunoassay. Serum GPDA isoenzymes and AFP were analyzed in 102 cases with PHC, 24 cases with chronic hepatitis, 45 cases with posthepatitic liver cirrhosis, 20 cases with metastatic liver cancer, 35 cases with benign liver filling defects and 80 healthy persons. Results: serum GPDA was separated into two bands, GPDA-S and GPDA- F. There was only GPDA-S in all healthy persons and cases with benign liver filling defects. In the cases with PHC the positive rate of GPDA-F was 85.3%, which was significantly higher than that in the cases with benign liver diseases. There was no correlation between GPDA-F and AFP. Conclusion: GPDA-F is a new hepatoma marker, which is helpful to the diagnosis of PHC, especially for AFP negative PHC. Simultaneous measurement of GPDA-F and AFP may raise the diagnostic level to PHC.