γ-谷氨酰移换酶同功酶Ⅱ和甲胎蛋白联检诊断原发性肝癌

Combining γ-glutamyl Transferase Isoenzyme Ⅱ with AFP for the Diagnosis of Primary Hepatic Carcinoma

目的 探讨γ 谷氨酰移换酶同功酶Ⅱ (γ GTⅡ )和AFP联合检测对原发性肝癌 (PHC)的诊断效果。方法 采用聚丙烯酰胺凝胶垂直平板电泳法测定 13 8例肝癌 ,82例非肝癌以及 3 0例正常人的血清γ GTⅡ ,以AFP为对照。结果 原发性肝癌阳性率为 79.5 %,继发性肝癌为 43 .8%,胃肠道肿瘤为 10 .7%,良性肝胆疾病为 3 .7%,正常人为零 ,假阳性率 4.5 %,特异性95 .5 %。 12 2例原发性肝癌同时检测了AFP ,阳性率为 72 .1%,2项标志物联合检测的阳性率为 91.0 %。AFP阴性患者γ GTⅡ的阳性率为 5 0 .0 %,小肝癌的阳性率为 5 8.3 %。结论 γ GTⅡ对PHC有较高的敏感性和特异性 ,对AFP阴性肝癌和小肝癌亦有较高的诊断价值 ,和AFP联合检测可进一步提高PHC的诊断率。

Objective To investigate the diagnostic value of combining γ glutamyl transferase isoenzyme Ⅱ(γ GTⅡ) and AFP for PHC(primary hepatic carcinoma).Methods Serum γ GTⅡwere determined in 122 cases of PHC(primary hepatic cancer),16 MHC(metastetic hepatic cancer),28 GI tumors,54 benign liver and biliary disease and 30 healthy controls.Results The positive rates of γ GTⅡ were 79.5%,43.8%,10.7%,3.7% and 0 respectively.False positive rate was 4.5%,specificity was 95.5%. The positive rate of γ GTⅡ was 50.0% in AFP negative patients with PHC,58.3% in small liver cancer,diagnostic positive rate was 91.0% in PHC when combining γ GTⅡand AFP determination was used.Conclusion Authors considered that the serum γ GTⅡ is a marker with high sensitivity and specificity for PHC diagnosis.Combination of γ GTⅡand AFP could further raise the detection rate of PHC.