肿瘤标志物在早期肝癌诊断中的价值

The Value of Tumor Markers in the Diagnosis of Early Hepatocellular Carcinoma

甲胎蛋白(AFP)是最早诊断肝癌的肿瘤标志物,对早期肝癌有较高的诊断价值,但仍有约1/3的早期肝癌AFP阴性。AFP异质体3是AFP中与肝癌相关的组分,高敏检测法对早期肝癌诊断的敏感性高于AFP。高尔基体蛋白73与肿瘤大小及分化程度无关,对AFP阴性的早期肝癌有很高阳性率,且与AFP有互补作用。异常凝血酶原、骨桥蛋白与磷脂酰肌醇蛋白聚糖3在早期肝癌有较高敏感性,且AFP阴性者也有较高阳性率。上述肿瘤标志物联合检测,可提高早期肝癌诊断率。

Alpha-fetoprotein（ AFP） is the earliest tumor markers for the diagnosis of hepatocellular carcinoma（ HCC） with high diagnostic value of early HCC,but there is still about one-third early HCC patients＇ AFP are negative. Using highly sensitive method of Lens culinaris agglutinin-reactive fraction of AFP（ AFP-L3）,which is the submit of AFP associated with HCC,is more sensitive and specific than AFP itself in the diagnosis of HCC in the early stage. In addition,Golgi protein 73 has no correlation with tumor size and differentiation but it plays an complementary role of AFP and has high positive rate in AFP negative early HCC. Moreover,des-gamma-carboxy prothrombin,osteopontin,glypican-3 have not only higher sensitivity in the early HCC,but also higher positive rate of AFP negative HCC. The combination of these tumor markers can significantly improve diagnosis of early HCC.