DCP、AFP-L3和AFP在原发性肝细胞癌诊断中的价值

Diagnostic Value of Des-gamma Carboxyprothrombin(DCP),Lectin-bound AFP(AFP-L3) and Alpha-fetoprotein(AFP) Expression in Primary Hepatocellular Carcinoma

目的:探讨血清中脱γ一羧基凝血酶原(DCP)、甲胎蛋白异质体(AFP-L3)和甲胎蛋白(AFP)对原发性肝细胞癌(PHC)单独和联合诊断的意义,为PHC诊治提供一种新方法,以及对高危人群作筛选。方法:采集53例PHC、51例肝硬化、60例慢性肝炎和52例健康对照者的血清分别检测DCP、AFP-L3和AFP,并对其统计分析。结果:PHC患者的DCP、AFP-L3和AFP均显著高于肝硬化、慢性肝炎和健康对照者,DCP、AFP-L3和AFP在PHC组中的灵敏度分别为77.36%、69.8 1%和60.38%,特异性分别为89.57%、88.34%和77.91%。三者联检时,其诊断的敏感度可提高至94.34%。结论:DCP对PHC诊断具有较好的敏感度和特异性,联检DCP、AFP-L3和AFP可有效提高PHC尤其是AFP阴性PHC的诊断效率,对PHC的早期诊治具有一定指导意义。

Objective To observe the alone and joint diagnostic value of des-gamma carboxyprothrombin （DCP）, lectin-bound AFP（AFP-L3） and alpha-fetoprotein（AFP） in primary hepatocellular carcinoma, and provide a novel method for diagnosis for PHC and screening for high risk population. Methods The levels of serum DCP, AFP-L3 and AFP were measured in 53 patients with hepa- toceUular carcinoma, $1 cases of cirrhosis, 60 cases of chronic hepatitis, 52 normal healthy subjects established as control group, and analyse the result statistically. Results The levels of serum DCP,AFP-L3 and AFP were significantly higher in the hepatocellular carcinoma than those in other groups. The diagnostic sensitivities of DCP, AFP-L3 and AFP to hepatocellular carcinoma were 77.36%, 69.81% and 60.38% respectively, the specificity were 89.57%, 88.34% and 77.91%, individually. The joint detection could improve sensitivity up to 94.34%. Conclusion DCP was a high sensitivity and specificity marker for diagnosis of PHC. The combined assay of serum tumor markers possess more value in the diagnosis of PHC, especially in AFP negative patients.