DCP和AFP-L3在AFP低浓度原发性肝癌诊断中的意义

Significance of DCP and AFP- L3 expression in primary hepatocellular carcinoma with low level of AFP

目的探讨血清中脱γ-羧基凝血酶原(DCP)和甲胎蛋白异质体(AFP-L3)对低浓度AFP原发性肝细胞癌(PHC)的应用价值。方法采收集51例低浓度AFP PHC患者、52例非肝癌患者和101例健康对照者的血清分别检测DCP和AFP-L3,并对其统计分析。结果低浓度AFP PHC患者的DCP和AFP-L3阳性率显著高于非肝癌和健康对照者(P<0.05),而非肝癌组和健康对照组两者差异无统计学意义(P>0.05)。DCP和AFP-L3诊断低浓度AFP PHC的灵敏度分别为76.47%(39/51)和70.59%(36/51),特异性分别为96.08%(147/153)和94.12%(144/153)。两项串联检测时,其诊断的特异性略微提高至98.69%(151/153),并联检测时敏感度显著提高至90.20%(46/51)。结论DCP和AFP-L3对低浓度AFP PHC患者具有较强的诊断效能,两项并联检测能有效避免一些漏检病例。

Objective To explore the clinical value of des - gamma carboxyprethrombin （ DCP）, and alpha - fetoprotein - L3 （ AFP - L3） ） in diagnosing primary liver cancer （PHC） with low level of AFP. Methods The DGP and AFP - L3 were detec- ted in 51 cases of primary liver cancer, 52 cases of liver cirrhosis and chronic hepatitis B, and 101 healthy controls. The SPSS statistical software was used for statistical analysis. Results The positive rate of DCP and AFP - L3 were significant higher in primary liver cancer with low level of AFP group than other groups （P 〈 0.05 ）, and no difference between other liver disease group,and healthy control group. The sensitivity of DCP and AFP -L3 were 76.47% and 70.59%, respectively; the specificity were 96.08% and 94.12%, respectively. The sensitivity and specificity of combined detection of the two parameters were high- er than detection of only one parameter. Condusion The DCP and AFP - L3 have very important meaning in the diagnosis for PHC with low concentration AFP; combined detection of them can avoid in some missing cases.