两种免疫分析法检测甲胎蛋白在原发性肝癌诊断中的价值

目的分别用时间分辨荧光免疫分析(TRFIA)和化学发光免疫分析(CLIA)法检测血清甲胎蛋白(AFP)浓度,比较两种检测方法对原发性肝癌(PHC)诊断的临床应用价值。方法选择门诊和住院期间确诊的PHC患者114例和肝良性病变患者126例,分别用TRFIA和CLIA法检测受试者血清AFP浓度,并进行工作特征(receiver operating characteristic curves,ROC)曲线分析。结果以健康对照组95%可信区间为医学正常值范围,TRFIA法和CLIA法诊断肝癌的临床界限值分别为7.31ng/mL和24.17ng/mL。TRFIA诊断肝癌的灵敏度为46.9%,特异性为93.4%,诊断准确率为79.2%。CLIA法的灵敏度为41.2%,特异性为91.6%,诊断准确率为65.8%。两种检测方法ROC曲线下面积分别为0.761(TRFIA)和0.682(CLIA)。结论TRFIA和CLIA法都可以满足临床AFP检测需要,但TRFIA法优于CLIA法。

加味逍遥散联合解毒疏肝汤治疗肝郁脾虚型原发性肝癌介入术后综合症的疗效及对血清HS-AFP水平的影响

目的:探讨加味逍遥散联合解毒疏肝汤在肝郁脾虚型原发性肝癌(PLC)介入术后综合症中的治疗价值,分析其对患者肝功能、血清肝癌特异性甲胎蛋白(HS-AFP)的影响。方法:选取2018年2月~2020年2月沧州市传染病医院收治的肝郁脾虚型PLC肝动脉栓塞化疗术(TACE)后综合征患者102例,随机数字表法分成观察组和对照组,各51例。对照组给予常规对症处理,观察组在对照组基础上给予加味逍遥散联合解毒疏肝汤治疗。比较两组治疗效果以及治疗前后的中医证候积分,分别在治疗前后检测两组肝功能指标,包括总胆红素(TBil)、谷氨酰转移酶(γ-GT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷丙转氨酶(ALT)水平,与此同时,检测并比较两组血清HS-AFP表达的变化,记录两组TACE所致毒副反应发生率。结果:观察组总有效率为94.12%,高于对照组的80.39%(P<0.05)。两组治疗后中医证候积分及血清TBil、γ-GT、AST、ALP、ALT均低于治疗前,且观察组中医证候积分及血清TBil、γ-GT、AST、ALT低于对照组(P<0.05)。观察组治疗后的血清HS-AFP阳性率为33.33%,显著低于对照组的54.90%(P<0.05)。观察组(25.49%)毒副反应发生率与对照组(31.37%)比较无差异(P>0.05)。结论:加味逍遥散联合解毒疏肝汤能更有效改善肝郁脾虚型PLC介入术后综合症患者的中医症状与肝功能,降低HS-AFP阳性率,提升总体疗效,且未增加TACE术后毒副反应发生率。

血清AFP和AFU联合检测对原发性肝癌诊断的临床意义

目的:探讨血清甲胎蛋白AFP,a-L-岩藻糖苷酶(AFU)联合检测对原发性肝癌诊断的临床价值。方法:正常健康对照组98例,原发性肝癌组67例,肝硬化组54例,均同时检测血清AFP,AFU.结果:原发性肝癌组、肝硬化组、正常健康对照组AFP AFU值比较差异有统计学意义P<0.01.原发性肝癌组血清AFP、AFU单项检测的敏感性为68.6%86.6%联合检测的AFP、AFU的敏感性为92.5.0%。结论:联合检测AFP、AFU可以提高原发性肝癌,尤其是AFP阴性的原发性肝癌的诊断率。

血浆长链非编码RNA HOTTIP与ROR联合高尔基体蛋白73对甲胎蛋白阴性肝癌的诊断与预后评估价值

目的探讨长链非编码RNA(long non-coding RNAs,lncRNAs)HOTTIP与ROR联合高尔基体蛋白73(Golgi protein 73,GP73)在甲胎蛋白(alpha-fetoprotein,AFP)阴性肝癌(AFP-negative hepatocellular carcinoma,AFP-NHCC)中的临床价值。方法 AFP-NHCC患者100例为AFP-NHCC组,肝脏良性疾病患者100例为肝脏良性疾病组,体检健康者110例为健康对照组。采用实时荧光定量PCR法检测3组血浆lncRNA HOTTIP、ROR,采用ELISA法检测3组血浆GP73,并进行组间比较;分析血浆lncRNA HOTTIP、ROR、GP73与AFP-NHCC临床特征的关系;绘制ROC曲线,分析血浆lncRNA HOTTIP、ROR与GP73对AFP-NHCC的诊断价值;多元logistic回归分析AFP-NHCC的危险因素。结果 AFP-NHCC组患者血浆lncRNA HOTTIP[12.8±0.6(-log)]、ROR表达[3.9±0.2(-log)]及GP73水平[(93.4±8.5)μg/L]高于肝脏良性疾病组[5.8±0.3(-log)、2.6±0.2(-log)、(30.8±3.7)μg/L]和健康对照组[5.7±0.2(-log)、2.5±0.2(-log)、(27.2±1.6)μg/L](P<0.05);血浆lncRNA HOTTIP、ROR和GP73表达水平与AFP-NHCC患者的淋巴结转移(HOTTIP:r=0.567,P=0.002;ROR:r=0.552,P=0.006;GP73:r=0.535,P=0.011)及TNM分级(HOTTIP:r=0.559,P=0.001;ROR:r=0.539,P=0.007;GP73:r=0.538,P=0.017)呈线性关联;ROC曲线分析显示,血浆GP73、lncRNA HOTTIP、ROR诊断AFP-NHCC的灵敏度/特异度分别为80.4%/76.9%、86.1%/74.5%和69.3%/63.2%,而联合三者诊断AFP-NHCC的特异度为92.9%;logistic回归多因素分析显示,在校正年龄、性别、吸烟史、饮酒史等因素影响后,血浆高GP73、lncRNA HOTTIP和ROR水平仍是AFP-NHCC发病的独立危险因素(OR=3.51,95%CI:1.53～5.72,P<0.001;OR=1.12,95%CI:1.03～1.34 P=0.032;OR=2.77,95%CI:1.47～5.08,P<0.001)。结论血浆lncRNA HOTTIP、ROR和GP73在AFP-NHCC的诊断以及评估AFP-NHCC患者发生肿瘤远处转移中有重要临床意义。

血清标志物在肝癌早期诊断中的研究进展

目前临床上诊断肝癌多以病理组织学及影像学为主要依据,但只有在瘤体长到一定体积时才能诊断,此时肿瘤已大多进入晚期,患者预后差。血清甲胎蛋白(AFP)作为肝癌筛查的主要血清学指标,由于敏感性不高导致其诊断的准确性差强人意,因此临床上迫切需要寻找新的肝癌血清标志物。本文将针对近年来肝细胞癌血清学诊断进展做一综述。

抗-PTCH1自身抗体在甲胎蛋白阴性肝癌中的诊断价值

目的探讨血清中抗-PTCH1自身抗体对甲胎蛋白(AFP)阴性肝癌的诊断价值。方法在2019年3月—2022年9月应用间接酶联免疫吸附实验(ELISA)检测来自于郑州(176例)、南昌(49例)和北京(38例)3个临床中心共计263例AFP阴性肝癌和对照血清中抗-PTCH1自身抗体水平;非参数检验(Mann-Whitney U test)比较病例组和对照组血清抗-PTCH1自身抗体水平的差异;绘制ROC曲线,计算ROC曲线下面积(AUC)、灵敏度、特异度等指标评价其诊断AFP阴性肝癌的价值;探讨抗-PTCH1自身抗体与临床生化指标联合应用于AFP阴性肝癌的诊断效果。结果3个临床中心的AFP阴性肝癌患者组血清抗-PTCH1自身抗体水平均高于对照组(P<0.05);抗-PTCH1自身抗体在郑州、南昌和北京诊断AFP阴性肝癌的ROC曲线下面积分别为0.692、0.763和0.845,灵敏度分别为44.3%、50.0%和40.0%,特异度分别为81.0%、88.0%和100.0%;联合临床指标AST和ALT构建诊断模型后在郑州、南昌和北京诊断AFP阴性肝癌的ROC曲线下面积分别为0.844、0.843和0.873。结论抗-PTCH1自身抗体对临床AFP阴性肝癌患者有一定诊断价值,联合临床指标ALT和AST的诊断AFP阴性肝癌效果更好。

联合检测血清AFP、AFU对原发性肝癌诊断的临床价值

目的:探讨血清甲胎蛋白(AFP)、a-L-岩藻糖苷酶(AFU)联合检测对原发性肝癌(primary hepatic carcinoma,PHC)诊断的临床价值。方法:设PHC组35例、良性肝病组38例及健康对照组40例,检测各组AFU及AFP含量并对各组检测结果及阳性率进行分析。结果:PHC组和良性肝病组血清AFP、AFU水平明显高于健康对照组(P<0.05);PHC组AFP、AFU水平明显高于良性肝病组(P<0.05);PHC组和良性肝病组AFP、AFU及AFP+AFU阳性率明显高于健康对照组(P<0.05);PHC组AFP、AFU及AFP+AFU阳性率明显高于良性肝病组(P<0.05);各组AFP+AFU阳性率明显高于AFP、AFU单独检测阳性率(P<0.05)。结论:AFU与AFP联合检测对提高PHC的诊断率有重要价值。

评价血清中AFP、GGT及AKP检测对原发性肝癌的诊断价值

目的探求血清中AFP、GGT及AKP对原发性肝癌的诊断意义，并确定最佳诊断临界值，比较AFP、GGT及AKP的诊断价值探求检测原发性肝癌的最佳模式。方法对78例原发性肝癌（PHC）、78例其他良性肝病，检测血清AFP、GGT及AKP，绘制ROC曲线，比较这三种诊断试验的KOC曲线下面积。结果ROC曲线下面积AFP、GGT、AKP在Roc曲线下面积分别为：0．907±0．025、0．821±0．0340．891±0．026．AFP曲线下面积最大，GGT曲线下面积最小，具有较高诊断价值。AFP、GGT、AKP对PHC的临床诊断临界值为AFP为：300ng／mlGGT为：200U／L，AKP为：160U／L。综合评价本实验AFP＋AKP联合检波4优于其他模式。

异常凝血酶原PIVKA-Ⅱ在HBV相关肝癌中的诊断价值分析

目的分析异常凝血酶原PIVKA-Ⅱ在HBV相关肝癌中的诊断价值。方法选取352例2018年1月-2019年1月在我院治疗的肝癌患者,其中232例为HBV相关肝癌患者,将其列为观察组,另外120例为非HBV相关肝癌患者,将其列为对照组。对两组患者的PIVKA-Ⅱ、AFP水平进行检测,对其检测结果进行比较,并对PIVKA-Ⅱ和AFP对HBV相关肝癌的诊断准确率进行比较。结果观察组患者的PIVKA-Ⅱ以及AFP水平均高于对照组,差异明显(P<0.05),PIVKA-Ⅱ对HBV相关肝癌的诊断准确率(84.00%)高于AFP(75.00%),差异显著(P<0.05),有统计学意义。结论HBV相关肝癌患者的PIVKA-Ⅱ以及AFP水平均比较高,并且PIVKA-Ⅱ对患者的临床诊断准确率更高。

血清AFP和AFU联合检测在原发性肝癌诊断中的价值

目的探讨血清AFP和AFU联合检测在原发性肝癌(PHC)诊断中的价值。方法将80例PHC患者随机分为观察组和对照组各40例。观察组行α-L-岩澡糖苷酶(AFU)和甲胎蛋白(AFP)联合检测。对照组仅行AFP检测。比较2组检测阳性率。结果观察组检测阳性率为90.0%(36/40)高于对照组的67.5%(27/40),差异有统计学意义(P<0.05)。结论联合AFP和AFU,同时结合病史、影像诊断学或组织学资料综合判断,可提高PHC的检出率,

Expression of the Glypican-3 Gene in α-fetoprotein-negative Human Hepatocellular Carcinoma

Objective： To investigate the expression of Glypican-3 gene in （α-fetoprotein （AFP）-negative hepatocellular carcinoma （HCC） and clarify whether Glypican-3 expression is a useful parameter for the diagnosis of hepatocelhllar carcinoma （HCC）, especially for AFP-negative ones. Methods： Forty-one specimens of AFP-negative hepatocellular carcinoma and para-carcimoma tissue were studied for the expression of Glypican-3 by Northern blot. The expression of Glypican-3 protein was detected immunohistochemically with specific polyclonal antibody. Results： Northern blot analysis indicated that the expression of Glypican-3 mRNA was intensively detected in 30 of 41 AFP-negative HCC （73.17%）. In contrast, Glypican-3 mRNA was only weakly detected in 4 of the surrounding non-tumor liver tissues. There was significant difference in the Glypican-3 mRNA expression in large tumors （〉5 cm） （79.31%） and in small tumors （〈5 cm） （41.67%） （P〈0.01）. Gypican-3 mRNA was more frequently overexpressed in poorly differentiated HCC than in well differentiated ones （76.47% vs. 42.86%, P〈0.05）. The Glypican-3 expression was not correlated with age. sex. ttbsAg seropositivity, fibroeapsule, portal venous embolus and intrahepatic metastasis. The overexpression of Glypican-3 protein in HCC was targeted in tumor cells, not in bile duct cells and other interstitial cells. Conclusion： Glypican-3 was specially overexpressed in AFP-negative HCC, and its expression was closely correlated with the tumor size and tumor grade. Glypican-3 gene may play important roles in hepatocareinogenesis, and can be used as a new biochemical marker of HCC, especially for AFP-negative HCC.

HS-AFP GGT-Ⅱ及AFP预测肝硬化癌变的临床价值

目的:探讨肝癌特异性甲胎蛋白(HS-AFP)、甲胎蛋白(AFP)和γ-谷氨酰转肽酶同工酶Ⅱ(GGT一Ⅱ)对肝硬化患者肝癌发生风险的预警价值。方法:HS-AFP采用聚丙烯酰胺凝胶电泳技术(PAGE)结合Western blot分离检测。AFP采用放射免疫分析测定法。GGT-Ⅱ采用PAGE分离检测。对341例肝硬化患者进行跟踪随访18个月,了解肝癌发生情况,分析比较HS-AFP、GGT-Ⅱ和AFP预测肝硬化患者发生肝癌风险的价值。结果:6、12、18个月随访期内HS-AFP、GGT-Ⅱ两项指标阳性组癌变率高于阴性对照组;随访12个月以上AFP阳性组癌变率高于阴性对照组;Hs-AFP、GGT-Ⅱ阳性组癌变率高于AFP阳性组,但前两者差异不明显;HS-AFP与GGT-Ⅱ及AFP之间存在互补性,其中HS-AFP和GGT-Ⅱ联合检测预测肝硬化癌变的敏感性、特异性和准确度分别达71.6%、91.4%、91.6%。结论:HS-AFP、GGT-Ⅱ和AFP对肝硬化癌变均有预测价值;HS-AFP和GGT-Ⅱ预测肝癌的特异性、准确度优于AFP;HS-AFP与GGT-Ⅱ预测肝癌的特异性、准确度相似;多项指标联合检测可提高预测肝硬化癌变的敏感性、特异性和准确度,以HS-AFP和GGT-Ⅱ联合检测效果最优。

Efficacy of ultrasonography and alpha-fetoprotein on early detection of hepatocellular carcinoma

AIM： To evaluate the effectiveness of ultrasonographic screening for early detection of hepatocellular carcinoma （HCC）. METHODS： The data of 14 968 patients who had ultrasonography （US） for chronic liver diseases were collected into a database program from June 1995 to June 2005. The risk factors for HCC were also studied. A total of 6089 patients who had repeated US were enrolled, 264 patients were diagnosed with HCC during follow-up （mean, 39 mo）. RESULTS： The detection rate of small HCC （≤ 3 cm in diameter） was 67.7%. The tumor size detected by screening at the intervals of 6 mo was significantly smaller than that at longer intervals. Only 29.3% of HCC patients had an elevated serum alpha fetoprotein （AFP） level above 400 ng/mL. The risk of HCC development during follow-up was higher in patients with liver cirrhosis （10.9%） and hepatitis C （9.0%） than in patients with chronic hepatitis （4.2%）, hepatitis B （4.9%） and non-B, non-C hepatitis （NBNC, 3.9%）. CONCLUSION： US screening at a interval of 6 mo is beneficial to high-risk patients over 40 years old and the early detection of HCC prolongs survival.

α-fetoprotein,vascular endothelial growth factor receptor-1 and early recurrence of hepatoma

AIM:To investigate whether α-fetoprotein (AFP) and vascular endothelial growth factor receptor (VEGFR)-1 correlate with early recurrence of hepatoma/hepatocel-lular carcinoma (HCC).METHODS:From 2000 to 2005,114 consecutive pa-tients with HCC underwent primary curative hepatecto-my.The mean age was 60.7 (8.7) years and 94 patients were male.The median follow-up period was 71.2 mo (range:43-100 mo).Immediately prior to commencing laparotomy,5 mL bone marrow was aspirated from thesternum and collected in citrate-coated test tubes.The initial 2 mL of bone marrow aspirate was discarded in each case.AFP mRNA and VEGFR-1 mRNA in the bone marrow and peripheral blood (BM-and PH-AFP mRNA and BM-and PH-VEGFR-1 mRNA,respectively) were measured by real-time quantitative reverse transcription polymerase chain reaction.As normal controls,VEGFR-1 mRNA in the bone marrow and peripheral blood was also measured in 11 living liver donors.These data were evaluated for any correlation with early recurrence,comparing clinical and pathological outcomes.RESULTS:The cut-off value of the BM-AFP mRNA and PH-AFP mRNA level in patients with HCC was set at 1.92 × 10-7 and zero,respectively,based on data from the controls.A total of 34 (29.8%) and six (5.4%) patients were positive for BM-AFP mRNA and PH-AFP mRNA,respectively.The BM-VEGFR-1 mRNA levels in all HCC patients were higher than those in the normal con-trols,and this was the case also for PH-VEGFR-1mRNA.The 25-percentile values for the BM-and PH-VEGFR-1 mRNA in HCC patients were used as the cut-off values for assigning the patients into two groups based on these transcript levels.The High group for BM-VEG-FR-1 mRNA contained 81 (71.1%) HCC cases and the Low group was assigned 33 (28.9%) patients.These numbers for PH-VEGFR-1mRNA were 78 (75.0%) and 26 (25.0%),respectively.HCC recurred in 80 patients;in the remnant liver in 48 cases,in the remnant liver and remote tissue in 20,and in the remote tissue alone in 12.BM-AFP mRNA-positive cases showed a signifi-cantly higher rate of early recurrence (within 1 year of surgical treatment) compared with BM-AFP mRNA-negative patients (P=0.0091).Patients were classified into four groups according to the level/status of their BM-VEGFR-1 and BM-AFP mRNA as follows:group A (n=23),BM-VEGFR-1/BM-AFP mRNA=low/negative;group B (n=57) high/negative;group C (n=10) low/positive;group D (n=24),high/positive.This classifi-cation was found to correlate with a recurrence of thisdisease within 1 year (P=0.0228).The disease-free survival curve of group A was significantly better than that of groups B,C or D (P=0.0437,P=0.0325,P=0.0225).No other classification (i.e.,PH-VEGF-R1/BM-AFP,BM-VEGF-R1/PH-AFP,and PH-VEGF-R1/PH-AFP mRNA) showed such a correlation.CONCLUSION:The evaluation of BM-AFP and BM-VEG-FR-1 mRNA in patients with HCC may be a valuable pre-dictor of disease recurrence following curative resection.

Very high alpha-fetoprotein in a young man due to concomitant presentation of hepatocellular carcinoma and Sertoli cell testis tumor

Studies reported that there is a close relationship between hepatocellular carcinoma （HCC） and testis carcinoma. Both tumors can be presented as synchronal tumors, or as testicular metastases of HCC or as hepatic metastases of testicular tumor. HCC is one of the most common malignancies worldwide and the incidence of HCC increases with age. The relationship between hepatitis B incidence and HCC rates is also well recognized. Alpha fetoprotein （AFP） is produced by 70% of HCC. Though a level of AFP 〉400 ng/mL is diagnostic for HCC, in the presence of active hepatitis B infection, the cut-off level should be considered to be at least 1 000-4 000 ng/mL. Like HCC, germ cell tumors of the testis also release AFP; but it is shown that some of Sertoli cell tumors of testis can also release AFP. Herein we have reported about the first case of HCC in the literature which is presented concomitantly with Sertoli-Leydig tumor of testis, leading to extremely high level of AFP in a 21-year-old man.

Highlights for α-fetoprotein in determining prognosis and treatment monitoring for hepatocellular carcinoma

AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy included terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summa-rized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios(HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks(RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles(12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55(95%CI,0.47-0.65) across HCC in overall survival(OS) and 0.50(95%CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64(95%CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39(95%CI,0.29-0.53).We showed a larger pooled HR in the 50% definition studies(HR,0.67,95%CI,0.55-0.83) compared with that from the 20% definition studies(HR,0.41,95%CI,0.32-0.53).Restricting analysis to the four studies including over 100 patients individually,the pooled HR was 0.65(95%CI,0.54-0.79),with a pooled HR for OS of 0.35(95%CI,0.23-0.46) in the studies of less than 100 patients.As to radiological imaging,43.1%(155/360) of the patients in the AFP response group presented with a radiological overall response,while the response rate decreased to 11.5%(36/313) in the patients from theAFP nonresponse group.The RR of having no overall response was significantly lower in the AFP response group than the AFP nonresponse group(RR,0.67;95%CI,0.61-0.75).In terms of disease control rate,86.9%(287/330) in the AFP response group and 51.0%(153/300) in the AFP nonresponse group showed successful disease control,respectively.The RR of disease control failure,similarly,was significantly lower in the AFP response group(RR,0.37;95%CI,0.23-0.58).But these findings could be overestimates because of publication and reporting bias.CONCLUSION:HCC patients presenting with an AFP response are at decreased risk of mortality.In addition,patients with an AFP response also present with a higher overall response rate and disease control rate.

Clinical evaluation of single or joint of golgi protein 73 and alpha-fetoprotein in hepatocellular carcinoma diagnosing

Objective: The aim of the present study was to further evaluate the clinical value of single or joint of golgi protein 73 (GP73) and alphafetoprotein (AFP) in diagnosis of hepatocellular (HCC). Methods: One hundred and eighteen, 94 and 47 serum samples from the patients with HCC, chronic liver disease (CLD) and liver cirrhosis (LC) were collected, respectively. Serum levels of AFP and GP73 were assayed with commercial kit according to the manufacturer's instructions. Results: Patients with HCC had higher serum concentration of AFP than that of the patients with CLD (P < 0.01), but was similar to that of the patients with LC. Serum GP73 levels in the patients with CLD or LC were significantly lower than that in the patients from HCC group (P < 0.01). Among 118 HCC patients, the positive rate of GP73 and AFP was 80.5% and 48.3%, respectively (P < 0.001). The ROC curve analysis showed that the AUC value of GP73 was higher than that of serum AFP. Moreover, the sensitivity and the accuracy of GP73 were 77.1% and 82.6%, respectively, which were greater more than that of AFP at 90% specificity (28.8% and 59.8%, respectively). The AUC, the sensitivity and the accuracy of GP73 in combination of AFP (AFP/GP73) were 0.855, 78.0% and 83.0%, respectively, which were similar to that of GP73 alone but were much higher than that of the single marker AFP. Conclusion: For HCC diagnosing, GP73 was more sensitive and specific than AFP. The diagnostic value of AFP/GP73 was similar to GP73 but was much higher than AFP.

Alpha-fetoprotein-producing rectum adenocarcinoma:A case report

A case with an Alpha-fetoprotein-producing(AFP-producing) carcinoma originating from the rectum was described.A 41-year-old man,who underwent a palliative surgery for rectal carcinoma,was diagnosed with occupying liver lesions and a remarkable AFP elevation(3484.61 ng/mL),and the AFP declined obviously 10 days after the palliative surgery.So we carried out a biopsy of the liver lesions.The histopathology was reported as low differentiation adenocarcinoma.The immunohistochemistry of the tumor cells via liver biopsy showed:Villin,CDX-2 was positive,Glypican-3 was partial positive,CK7,CK20,AFP,Hepatocyte were all negative.The initial histopathology was reported as an AFP-producing rectum adenocarcinoma with liver metastasis,which was a rare disease.So far,only 17 reports,none has been reported in China.Then,we summarize the characteristic of the disease:diagnosed with hepatic metastasis,raised serum AFP and a poor outcome,in addition to primary symptoms.This kind of disease is highly malignant.

原发性肝癌的特异性生物学标志物的分析

目的探讨肝癌特异性甲胎蛋白(HS-AFP)、甲胎蛋白(AFP)和γ-谷氨酰转肽酶同工酶Ⅱ(GGT-Ⅱ)对肝硬化患者肝癌发生风险的预警价值。方法对452例肝硬化患者进行跟踪随访15个月,了解肝癌发生情况,分析比较HS-AFP、GGT-Ⅱ和AFP预测肝硬化患者发生肝癌风险的价值。结果 HS-AFP、GGT-Ⅱ阳性组癌变率高于AFP阳性组,但前两者差异不明显;HS-AFP与GGT-Ⅱ及AFP之间存在互补性,其中HS-AFP和GGT-Ⅱ联合检测预测肝硬化癌变的敏感性、特异性和准确度分别达73.2%、93.1%、92.3%。结论 HS-AFP、GGT-Ⅱ和AFP对肝硬化癌变均有预测价值;HS-AFP和GGT-Ⅱ预测肝癌的特异性、准确度优于AFP;HS-AFP与GGT-Ⅱ预测肝癌的特异性、准确度相似;多项指标联合检测可提高预测肝硬化癌变的敏感性、特异性和准确度。