肝细胞癌患者血清中循环无细胞DNA、甲胎蛋白及a-L-岩藻糖苷酶联合检测的意义

Significance of combined detection with CfDNA,AFP and AFU in the diagnosis of hepatocelluar carcinoma

目的探讨循环无细胞DNA(cfDNA)在肝细胞癌(HCC)中检测的价值及其与甲胎蛋白(AFP)、a-L-岩藻糖苷酶(AFU)联合检测的临床诊断价值。方法收集39例HCC患者血清以及45例正常对照血清,采用分支DNA(branched DNA,bDNA)技术检测血清中cfDNA的浓度,同时采用化学发光法检测血清中AFP的浓度,比色法测定血清AFU的活性,并讨论这三种生物标志物联合检测的意义。结果 39例HCC患者血清中有22例cfDNA含量增高,45例正常对照血清中有2例cfDNA含量增高,HCC患者血清cfDNA阳性表达率均显著高于正常对照者(P<0.05);cfDNA与AFP、AFU的一项或者两项联合检测敏感性分别为71.8%、87.2%、89.7%,明显高于单独一项检测敏感性分别为56.4%、53.8%、66.7%,差异有统计学意义(P<0.05)。经相关性分析,cfDNA、AFP与AFU这三种生物标志物均无相关性。结论定量分析cfDNA的方法用于HCC的检测是一种敏感、有效的方法,与AFP、AFU联合检测可以大大提高HCC的临床诊断。

Objective To investigate the value of circulating free cell DNA （cfDNA）for the diagnosis of hepatocellular carcinoma （HCC）,and to explore the value of combined detection of cfDNA,AFP and AFU for the clinical diagnosis.Methods Serum samples from 39 HCC patients and 45 normal controls were collected.Branched DNA（bDNA）was used to detect the level of cfDNA,while AFP （a-fetoprotein）and AFU （a-L-fucosidase）were detected by chemiluminescence and colorimetry respectively.The significance of com-bined detection of the three biomarkers was discussed.Results cfDNA level was increased in 22 of the 39 HCC samples and 2 of the 45 normal controls.cfDNA level in HCC samples was significantly higher than that in normal controls （P 〈0.05）.The sensitivities of combined detection with one item（cfDNA and AFP,cfDNA and AFU）,and with two items（cfDNA ,AFP and AFU）were 71.8%, 87.2% and 89.7% versus 56.4%,53.8% and 66.7% for cfDNA and AFP,AFU alone respectively,the difference being statistically significant（P 〈0.05）.By the correlation analysis,there was no significant correlation between cfDNA,AFP and AFU in the detection of HCC.Conclusions Quantitative analysis of cfDNA is sensitive and feasible,and combined detection of cfDNA with AFP or AFU or both can improve the diagnostic sensitivity for HCC.