AFP-L3检测在良恶性肝病鉴别诊断及肝癌预警中的临床意义

Investigation the clinical significance of alpha fetoprotein heterogeneity in the differential diagnosis of benign and malignant liver disease

目的:探讨甲胎蛋白异质体在良恶性肝病鉴别诊断及肝癌预警中的临床意义。方法:200例肝病患者血清,其中肝癌98例,肝硬化46例、慢性肝炎56例,分别检测AFP以及AFP-L3含量,计算AFP-L3占总AFP的比率,对AFP-L3异常升高非肝癌患者进行跟踪。结果:肝癌患者血清中AFP-L3数值及阳性率明显高于肝硬化、慢性肝炎组(P<0.01);AFP-L3诊断肝细胞癌灵敏度(72.3%),但特异性较高(97.0%),AFP-L3的百分比与AFP浓度不相关(r=0.16,P>0.05)。AFP-L3阳性的3例非肝癌患者,12个月内有3例发生肝癌。结论:检测甲胎蛋白异质体(AFP-L3)在良恶性肝病的鉴别诊断及肝癌预警中具有重要意义。

objective： To investigate the clinical significance of alpha fetoprotein heterogeneity in the differential diagnosis of benign and malignant liver disease and in the early warning of hepatocellular carcinoma. Methods： 200 cases of liver disease patients, including 98 cases of hepatocellular carcinoma, d6 cases of cirrhosis,56 cases of chronic hepatitis, to detect AFP and AFP - L3 content, AFP - L3 ratio of AFP to AFP - L3, the abnormal increaseof ＇alpha fetoprotein heterogeneity of non HCC patients were tracking. Results： Value of AFP - L3 in the sera of HCC patients and the positive rate was significantly higher than that of liver cirrhosis, chronic hepatitis group （ P 〈0.01 ） ; AFP - L3 diagnosis sensitivity of hepatic cell carcinoma （72.3%）, but higher specificity （97%）, not related to the percent- age of AFP - I_3 and the concentration of AFP （r =0.16, P 〉0.05）. 3 cases of non tumor patients with AFP - L3 positive, 12 months later were diagnosed as primary liver cancer. Conclusion： Detection of alpha fetoprotein heterogeneity （ AFP - L3 ） plays an important role in the differential diagnosis of benign and malignant liver disease and in early warning of liver cancer. Key words Alpha fetoprotein het- erogeneity ; Cancer; Liver cells ; Differential diagnosis ; Early warning