凝集素微量离心柱法检测甲胎蛋白异质体联合血清巨噬细胞抑制因子1对原发性肝癌的诊断价值

Significance of AFP-L3%Detected by Agglutinincoupled Spin Column Combined Serum Macrophage Inhibitory Factor 1 in Primary Liver Cancer Diagnosis

目的探讨凝集素微量离心柱法(ACSC)检测甲胎蛋白异质体(AFP-L3%)联合血清巨噬细胞抑制因子1(MIC-1)检测对原发性肝癌的诊断价值。方法选取我院2018年1月-2019年6月收治113例经临床确诊为原发性肝癌的患者设为观察组;选取同期49例健康体检者作为对照组。应用ACSC法检测原发性肝癌患者及健康体检者血清中的AFP-L3%,并应用酶联免疫吸附法(ELISA)检测原发性肝癌患者及健康体检者两组血清MIC-1浓度,分析两项指标联合检测对诊断原发性肝癌的临床效果。结果健康组的AFP-L3%和MIC-1的浓度均远低于肝癌组患者,差异有统计学意义(P<0.01),AFP-L3%诊断原发性肝癌的灵敏度为84.07%(95/113),特异度为85.71%(42/49),诊断正确率是84.57%(137/162);MIC-1浓度诊断原发性肝癌的灵敏度为84.95%(96/113),特异度为77.55%(38/49),诊断正确率是82.71%(134/162);AFP-L3%联合MIC-1浓度诊断原发性肝癌的灵敏度为91.15%(103/113),特异度为91.83%(45/49),诊断正确率是91.35%(148/162)。AFP-L3%联合MIC-1浓度诊断灵敏度、特异度,正确率均高于单一AFP-L3%、MIC-1。结论凝集素微量离心柱法检测甲胎蛋白异质体百分含量联合血清巨噬细胞抑制因子1浓度在原发性肝癌的诊断中,具有重要的临床价值,可明显提高诊断的特异性,值得在临床推广。

Objective Study the diagnosis value of alpha-fetoprotein isoforms 3(AFP-L3)detected by agglutinin-coupled spin column(ACSC)combined with expression of serum macrophage inhibitory factor 1(MIC-1)in primary liver cancer.Methods 113 patients with clinically confirmed primary liver cancer admitted to our hospital from January 2018 to June 2019 were selected,49 healthy subjects in the same period were compared.AFP-L3%were detected by ACSC and MIC-1 were detected by ELISA,analyze the clinical effect of combined detection and single detection the two indicators in the diagnosis of primary liver cancer.Results In health group AFP-L3%and MIC-1 concentration were far lower than the group of liver cancer patients,and there were statistically significant difference(P<0.01);The sensitivity of AFP-L3%in diagnosis of primary liver cancer was 84.07%(95/113),the specificity was 85.71%(42/49),and the diagnostic accuracy was 84.57%(137/162);MIC-1 detection sensitivity was 84.95%(96/113),specificity of 77.55%(38/49),the diagnostic accuracy was 82.71%(134/162);The sensitivity of AFP-l3%combined with mic-1 concentration to diagnose primary liver cancer was 91.15%(103/113),the specificity was91.83%(45/49),the diagnostic accuracy was 91.35%(148/162).Conclusion Alpha-fetoprotein isoforms 3(AFP-L3%)detected by agglutinin-coupled spin column combined with the expression of serum macrophage inhibitory factor 1(MIC-1)in primary liver cancer has important clinical value,it can obviously increase the diagnostic specificity and is worth popularizing in clinical.