甲胎蛋白异质体L3在甲胎蛋白低浓度时预警肝癌的研究

Study of early warning of liver cancer by AFP-L3 determined in AFP low concentrations

目的探讨甲胎蛋白异质体L3(AFP-L3)的检测在甲胎蛋白低浓度时预警肝癌的作用。方法 114例AFP升高肝病患者的血清,采用微量离心柱法获得AFP-L3,再与原血清同时检测AFP含量,计算AFP-L3在AFP中的比例,对AFP低浓度的37例疑似肝癌患者进行跟踪6～10个月,分析AFP-L3升高者在预警肝癌中的作用。结果肝癌组、疑似肝癌组AFP-L3阳性率明显高于良性肝病组(80.77%,62.16%,11.76%,P<0.05);AFP低浓度(52.21～384.18 ng/ml)的37例疑似肝癌患者中,AFP-L3阳性23例,其中14例于6个月后诊断为肝癌,4例于10个月后诊断为肝癌,在18例诊断为肝癌的患者中,有3例通过影像学早期诊断为单发小肝癌;AFP-L3的百分比与AFP浓度不相关(r=0.19,P>0.05)。结论 AFP-L3在AFP低浓度时对于肝癌的早期预警诊断具有重要意义。

Objectives To investigate the role of early warning of liver cancer by alpha-fetoprotein heterogeneity L3（AFP-L3） determined in the alpha-fetoprotein low concentrations.Methods The serum of 114 cases of liver disease patients with AFP increased,serum AFP-L3 variants were separated by micro-centrifugal column,the serum AFP-L3 and the original serum AFP levels were detected at the same time.To calculate the proportion of AFP-L3 in AFP,37 cases of suspected liver cancer patients with low AFP concentrations were tracked 6～10 months,the warning of HCC were analysised by AFP-L3 elevated.results：Compared with benign liver disease group the serum AFP-L3 positive rate was significantly higher than HCC group and suspected liver cancer group（80.77%,62.16%,11.76%,P0.05）;23 cases of AFP-L3 positive patients among 37 cases suspected liver cancer patients with AFP low concentrations（52.21～384.18 ng/ml）,14 cases in 6 months after diagnosis of liver cancer and 4 cases in 10 months,3 cases were early diagnosis of single small hepatocellular carcinoma by imaging in 18 cases diagnosed with liver cancer;no correlation was found between AFP-L3 percentage and AFP concentration（r=0.19,P0.05）.Conclusions The detection of alpha-fetoprotein heterogeneity L3（AFP-L3） in alpha-fetoprotein low concentrations are significance for the diagnosis of early liver cancer.