血清AFP、AFP-L3、AFU、GP73联合检测对原发性肝癌的诊断价值

Diagnostic value of combined detection of serum alpha fetoprotein, alpha fetoprotein heterogeneity L3,α-L-fucosidase, and Golgi glycoprotein 73 in primary liver cancer

目的研究血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、α-L-岩藻糖苷酶(AFU)、高尔基体糖蛋白73 (GP73)联合检测对原发性肝癌的诊断价值。方法选择上海市养志康复医院(上海市阳光康复中心) 2018年2月至2020年10月期间收治的66例原发性肝癌患者作为观察组,选择同期在上述医院体检的66例健康体检者作为对照组。检测并比较两组受检者血清AFP、AFP-L3、AFU、GP73水平及阳性率,并分析各指标在原发性肝癌患者诊断中的灵敏度、特异性和准确度。结果观察组患者的血清AFP、AFP-L3、AFU及GP73水平分别为(219.56±17.94)μg/L、(15.78±4.56)%、(68.56±11.78) U/L、(208.89±48.76)μg/L,明显高于对照组的(17.19±3.15)μg/L、(3.89±0.78)%、(24.78±6.56) U/L、(67.46±15.78)μg/L,差异均有显著统计学意义(P<0.01);观察组患者血清中的AFP、AFP-L3、AFU及GP73检测阳性率分别为72.73%、63.64%、68.18%、77.27%,明显高于对照组的3.03%、3.03%、6.06%、4.55%,差异均有显著统计学意义(P<0.01);各项指标对原发性肝癌均有一定的诊断价值,联合诊断的准确度最高,为96.5%,四项指标中其特异性最高的AFP-L3为90.2%,灵敏度最高的AFU为74.6%,AFP-L3单独诊断准确度最高,为80.9%。结论血清AFP、AFP-L3、AFU、GP73可作为原发性肝癌患者的诊断指标,且联合检测能显著提高原发性肝癌的灵敏度、特异性和准确度,具有临床应用价值。

Objective To study the diagnostic value of combined detection of serum alpha fetoprotein(AFP),alpha fetoprotein heterogeneity L3(AFP-L3), α-L-fucosidase(AFU), and Golgi glycoprotein 73(GP73) in primary liver cancer. Methods Sixty-six patients with primary liver cancer treated in Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center) from February 2018 to October 2020 were selected as the observation group,and 66 healthy people who underwent physical examination in the hospitals in the same period were selected as the control group. The levels and positive rates of serum AFP, AFP-L3, AFU, and GP73 in the two groups were detected and compared, and the sensitivity, specificity, and accuracy of each index in the diagnosis of patients with primary liver cancer were analyzed. Results The levels of serum AFP, AFP-L3, AFU, and GP73 in the observation group were(219.56±17.94) μ g/L,(15.78 ± 4.56)%,(68.56 ± 11.78) U/L,(208.89 ± 48.76) μ g/L, significantly higher than(17.19 ± 3.15) μ g/L,(3.89±0.78)%,(24.78±6.56) U/L,(67.46±15.78) μg/L of the control group(P<0.01). The positive rates of serum AFP,AFP-L3, AFU, and GP73 in the observation group were 72.73%, 63.64%, 68.18%, and 77.27%, which were significantly higher than 3.03%, 3.03%, 6.06%, and 4.55% in the control group(P<0.01). All indexes have certain diagnostic value for primary liver cancer, and the accuracy of combined diagnosis is the highest(96.5%). Among the four indexes,AFP-L3 has the highest specificity(90.2%), AFU has the highest sensitivity(74.6%), and AFP-L3 alone had the highest diagnostic accuracy(80.9%). Conclusion Serum AFP, AFP-L3, AFU, and GP73 can be used as diagnostic indexes for patients with primary liver cancer, and the combined detection can significantly improve the sensitivity, specificity, and accuracy of primary liver cancer.