甲胎蛋白异质体和甲胎蛋白信使核糖核酸用于诊断肝细胞癌

Alpha Fetoprotein Heterogeneity and Alpha Fetoprotein Messenger Ribonucleic Acid for Diagnosis of Hepatocellular Carcinoma

目的:探讨联合检测2种血清肿瘤标志物甲胎蛋白(AFP)异质体(AFP-L3)和甲胎蛋白信使核糖核酸(AFPmRNA)诊断肝细胞癌价值及评估肝癌预后的意义。方法:对2005年4-7月收治的82例肝细胞癌(HCC)、11例慢性乙型肝炎肝硬化合并门脉高压和19例肝脏良性肿瘤患者应用酶联吸附法及荧光定量PCR联合检测AFP-L3和AFPmRNA水平,对比其阳性率;并对术后1个月的肝癌患者检测AFP-L3和AFPmRNA水平,统计作出生存曲线。结果:术前不同肿瘤指标的检测结果:AFP-L3联合AFPmRNA检测阳性率为64.3%,明显高于AFP、AFP-mRNA单独检测的阳性率(50.9%、40.2%),差异均有统计学意义(P<0.05);术前、术后AFP-L3联合AFPmRNA检测均阳性的患者术后3年生存率较低。结论:术前联合检测APF-L3和AFPmRNA两项指标可提高HCC、尤其是AFP阴性HCC的诊断率,而术后联合检测又对评估HCC的预后有一定的指导意义。

Objective：To investigate the combined detection of 2 tumor markers in serum alpha fetoprotein（AFP）variants（AFP-L3）and alpha fetoprotein messenger ribonucleic acid（AFPmRNA）value and evaluate prognosis significance in diagnosis of hepatocellular carcinoma.Method：From April to July 2005,82 cases of hepatocellular carcinoma（HCC）,11 patients with chronic hepatitis B cirrhosis with portal hypertension and 19 cases of benign liver tumors were treated with enzyme-linked assay and fluorescence quantitative PCR and detection of AFP-L3 and AFPmRNA level,compared the positive rate;and 1 month after the detection of liver cancer patients and AFPmRNA AFP-L3 level statistics make survival curve. Result：Through AFPmRNA and AFP-L3 joint detection,positive rate was 64.3%,significantly higher than the separate detecting AFP-L3,AFP,AFP-mRNA positive rate was high （50.9%,40.2%）. And there were statistically significant（P〈0.05）;Preoperative and postoperative joint detection of AFP-L3 and AFPmRNA positive patients with postoperative 3 year survival rate were low. Conclusion：Preoperative two indexes of combined detection of APF-L3 and AFPmRNA can improve the diagnosis of HCC,especially AFP negative rate of HCC,and after the combined detection of HCC and to evaluate the clinical significance.