• 1. Department of Nuclear Medicine Laboratory, The People’s Hospital of Tangshan, Hebei Union University, Tangshan, Hebei 063000, P. R. China; 2. Department of Clinical Laboratory, The Leting County Hospital, Tangshan, Hebei 063000, P. R. China;
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目的  通过检测肝病患者血清甲胎蛋白异质体(AFP-L3)浓度和AFP-L3/血清甲胎蛋白(AFP)比值,分析探讨并联运用两指标在肝细胞癌(HCC)诊断中的价值。 方法  选取2011年3月-11月137例的住院患者血清标本,AFP检测均为阳性。依据病理学诊断,将137例患者分为两组,HCC组92例,良性肝病组45例,后者包括肝硬化结节37例、慢性活动性肝炎8例。采用酶联免疫吸附试验(ELISA)检测所有患者血清AFP-L3浓度;同时运用微量吸附柱法分离血清中的AFP-L3,采用电化学发光法检测分离后的AFP-L3和血清中总AFP浓度,计算AFP-L3/AFP比值。计算采用AFP-L3浓度与AFP-L3/AFP比值以及AFP-L3浓度与AFP-L3/AFP比值两指标并联诊断HCC的灵敏度、特异度、Youden指数等统计学指标,探讨其在原发性肝癌诊断中的价值。 结果  ① HCC组 AFP-L3浓度(109.04 ± 62.51)ng/mL,明显高于良性肝病组(25.96 ± 49.43)ng/mL,差异有统计学意义(t=8.28,P<0.001)。HCC组血清AFP-L3/AFP比值(17.35 ± 14.48%)高于良性肝病组(5.617 ± 6.38%), 差异有统计学意义(t=6.545,P<0.0001)。② 以血清AFP-L3浓度>38.0 ng/mL作为临界值诊断原发性肝癌的灵敏度为83.69%,特异度为88.88%,以AFP-L3/AFP比值>10%作为临界值诊断原发性肝癌的灵敏度为83.69%,特异度为95.55%。③ 并联应用血清AFP-L3浓度>38.0 ng/mL、AFP-L3/AFP>比值7.5%诊断HCC的灵敏度为97.83%,特异度为84.44%。 结论  并联应运AFP-L3浓度与AFP-L3/AFP比值诊断HCC较应用单一指标诊断特异度稍有下降,但明显提高了诊断的灵敏度,更有利于HCC的早期诊断。

Citation: HUANG Caiyun,HAN Sugui,JIA Honglian.. The Value of Combined Serum Alpha-fetoprotein Heteroplasmon-L3 Concentration and AFP-L3/Alpha-fetoprotein Ratio Detection in the Early Diagnosis of Primary Liver Cancer. West China Medical Journal, 2013, 28(5): 724-727. doi: 10.7507/1002-0179.20130225 Copy

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