AFP、APF-L3、GP73、AFP-mRNA联合检测在肝细胞癌诊断中的应用价值

目的探讨甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体蛋白(GP73)及AFP-mR-NA联合检测在HCC诊断中的价值。方法收集175例血清、其中肝细胞癌患者73例(HCC组)、肝硬化患者41例(肝硬化组)、慢乙肝患者36例(慢性肝炎组)、正常人25例(正常人组),采用酶联免疫法检测GP73,用化学发光法检测AFP,用亲和吸附离心法检测AFP-L3,采用荧光定量逆转录聚合酶链反应(RT-PCR)法检测患者AFP-mRNA外周血的表达。结果 AFP、AFP-L3、GP73及AFP-mRNA在HCC组的含量与肝硬化组和正常组比较差异有统计学意义(P<0.01),通过ROC曲线评价,AFP、AFP-L3、GP73及AFP-mRNA的曲线下面积分别为0.691、0.859、0.816、0.762,敏感度分别为54.79%、76.71%、80.82%、53.42%,特异度分别为79.41%、95.10%、82.35%、99.02%,四者联合检测的ROC曲线下面积为0.958,联合检测的敏感度明显提高达95.8%,特异度为95.0%。结论 AFP、AFP-L3、GP73及AFP-mRNA四者联合检测可显著提高肝细胞癌诊断的灵敏度和特异度。优于AFP、AFP-L3、GP73和AFP-mRNA的单项检测。

Union examination of AFP,AFU,AFPL3 and γ-GT in early diagnosis of primary liver cancer

Objective To explore the significance of union examination of blood serum liver cancer tracers in the early diagnosis of liver cancer. Methods We observed and compared the level of blood serum liver cancer tracers armor embryo protein (AFP),crag algae glycosidase (AFU),armor embryo protein heteroplasmon (AFPL3) and γ-Gu Anxian transferase (γ-GT) in early time for primary liver cancer patients and hepatitis liver cirrhosis patients and those chronic hepatitis B patients who had liver cancer family history. Results Finally among the 30 patients in the early liver cancer group,23 were positive with AFP,20 with AFU,15 with AFPL3 and 21 with γ-GT. Five were found positive with blood serum AFP,AFPL3,AFU and γ-GT at the same time; 5 with AFP,AFPL3 and γ-GT; 5 with AFP,AFU and AFPL3; 7 with AFP,AFU and γ-GT. By contrast,in the control group,among the 30 hepatitis liver cirrhosis patients and those chronic hepatitis B patients with liver cancer family history,11 were found positive with AFP,3 with AFPL3,12 with AFU and 14 with γ-GT. None of the patients were found positive with union examination of AFP,AFPL3,AFU and γ-GT in the blood serum at the same time. Conclusion The union examination of AFP,AFU,AFPL3 and γ-GT is significant to the early diagnosis of primary liver cancer.

甲胎蛋白异质体的检测与临床应用的研究进展

肝细胞癌的临床早期诊断主要通过影像学和血清甲胎蛋白(AFP)的检查。但是AFP在肝癌的诊断中存在一定的假阴性和假阳性。国内外研究表明,AFP异质体在肝癌诊断与鉴别诊断中其敏感性与特异性高于AFP。由于AFP异质体是糖链结构不同的AFP,其分离检测主要基于与植物凝集素的不同亲和力。最新研究表明,AFP异质体还可以应用于临床多种疾病的诊断与预后。

甲胎蛋白异质体的检测在肝癌中的临床应用

目的探讨小扁豆凝集素结合型甲胎蛋白异质体(AFP-L3)在原发性肝癌诊断中临床应用价值。方法选择肝癌组52例、肝硬化组44例、慢性肝炎组63例,原发性胆汁性肝硬变21例。应用预装有耦联小扁豆凝集素的亲和微量离心柱分离血清AFP-L3,化学发光法检测AFP-L3和血清总AFP,计算AFP-L3在AFP中的含量比例,以AFP-L3(%)≥10%作为阳性判断标准,分析AFP-L3用于临床在鉴别原发性肝癌的作用。结果肝癌患者血清中AFP-L3(%)明显高于其它肝病患者(均P<0.01),以AFP-I3(%)≥10%作为诊断标准,在已经确诊为肝癌的患者中灵敏度是90.4%,与慢性肝病的鉴别诊断的特异性为96.1%。结论微量离心柱法检测甲胎蛋白异质体AFP-L3在肝癌与良性肝脏病变鉴别诊断中具有重要临床价值。