The Cinical Value of Alpha-fetoprotein-L3 Detected by Enzyme Linked Immunosorbent Assay in the Diagnosis of Primary Liver Cancer_West China Medical Journal

Authors：

HAN Sugui ,  HUANG Caiyun , LIU Hongmei , LI Guoan , ZHOU Xiuyan , LI Shilong

Laboratory Branch of Nuclear Medicine Department, the People’s Hospital of Tangshan City, Tangshan, Hebei 063001, P. R. China;

Corresponding author：

HUANG Caiyun, Email: hansugui2006@sina.com

Keywords：

甲胎蛋白; 原发性肝细胞癌; 甲胎蛋白异质体; 酶联免疫吸附试验

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目的　探讨酶联免疫吸附试验(ELISA)检测血清甲胎蛋白异质体(AFP-L3)含量对原发性肝癌（PLC）的诊断价值。方法　选择2011年3月－11月门诊或住院的137例患者临床检测甲胎蛋白(AFP)为阳性的肝病患者血清，应用上海逸峰生物科技有限公司提供的ELISA法AFP-L3检测试剂盒检测AFP-L3浓度，137例中男98例，女39例，年龄28～77岁。其中PLC 92例，良性肝病45例，后者包括肝硬化37例、慢性肝炎8例。分析PLC组与良性肝病组AFP-L3浓度差异，运用受试者工作特征曲线(ROC)分析AFP-L3含量在PLC鉴别诊断中的价值。结果　PLC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，两组差异有统计学意义（t=8.28 ，P＜0.001）。ROC分析结果显示，曲线下面积为0.819，以AFP-L3浓度37.89 ng/mL为临界值，分析92例PLC患者与45例良性肝病患者AFP-L3浓度异常的灵敏度为83.69%，特异度为88.88%，阳性预测值为93.90%（77/82），阴性预测值为72.72%（40/55），诊断准确度为85.40%。结论　应用简便快速的ELISA法检测AFP-L3浓度在PLC与良性肝病鉴别诊断中具有较高的临床价值，便于临床推广。

Citation： HAN Sugui,HUANG Caiyun,LIU Hongmei,LI Guoan,ZHOU Xiuyan,LI Shilong. The Cinical Value of Alpha-fetoprotein-L3 Detected by Enzyme Linked Immunosorbent Assay in the Diagnosis of Primary Liver Cancer. West China Medical Journal, 2012, 27(6): 874-876. doi: Copy

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11.	Li D, Mallory T. AFP-L3: a new generation of tumor marker for hepatocellular carcinoma[J]. Clin Chim Acta, 2001, 313(1): 15-19.
12.	FDA. ClassⅡspecial controls cuideline document: AFP-L3 % immunological test systems (FDA-2005-0030-0001)[EB/OL](2005-10-04)[2012-02-02]. http://www.fda.gov/ohrms/dockets/98fr/05d-0342-gdl0001.pdf.
13.	孔祥亘, 韩绍磊, 郑昭敏, 等．高尔基体蛋白73联合甲胎蛋白异质体在原发性肝癌诊断中的价值[J]．山东大学学报(医学版)，2011, 49(4): 110．.
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15.	青柳茔.肿瘤标志物的临床诊断意义及展望—甲胎蛋白(AFP)L3组分[J]. 日本医学介绍, 2005, 26(2): 49-50.
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1. 　俞顺章. 原发性肝癌流行病学研究进展[J]. 实用肿瘤杂志, 1998, 13(3): 130-133.
2. 　汤钊猷. 临床肝病学[M]. 上海: 科技教育出版社, 2001: 13.
3. 　贾志凌, 王莉, 刘畅, 等. 甲胎蛋白异质体对肝癌诊断的临床意义[J]. 中国肿瘤, 2010, 19(10): 686-688．.
4. 　Yamamoto K, Imamura H, Matsuyama Y, et al．AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC[J]. J Gastroentero, 2010, 45(12): 1272-1282.
5. 　Nakagawa T, Miyoshi E, Yakushijin T, et a1. Glycomic analysis of alpha-fetoproteinL. 3 in hepatoma cell lines and hepatocellar carcinoma patients[J]. J Proteome Res, 2008, 7(6): 2222-2233.
6. 　中华医学会传染病与寄生虫病学分会和肝病学分会. 病毒性肝炎防治方[J]. 中华肝脏病杂志, 2000, 8(4): 324-329.
7. 　中国抗癌协会. 新编常见恶性肿瘤诊治规范(原发性肝癌分册) [M ]. 北京: 北京医科大学与中国协和医科大学联合出版社，1999: 22-23.
8. 　王根芬. 三种肿瘤标志物对原发性肝癌诊断的联合应用价值[J]. 临床医学, 2008, 27(11): 56-58.
9. 　孙桂珍, 赵秀英, 李俊红, 等. 凝集素微量离心柱法检测甲胎蛋白异质体用于肝癌的诊断及分析[J]. 中华医学杂志, 2008, 88(28): 1986-1988.
10. 　Fujiyama S, Tanaka M, Maeda S, et al. Tumor markers in early diagnosis, follow-up and management of patients with hepatocellular carcinoma [J]. Oncology, 2002, 62(Suppl1): 57-63.
11. 　Li D, Mallory T. AFP-L3: a new generation of tumor marker for hepatocellular carcinoma[J]. Clin Chim Acta, 2001, 313(1): 15-19.
12. 　FDA. ClassⅡspecial controls cuideline document: AFP-L3 % immunological test systems (FDA-2005-0030-0001)[EB/OL](2005-10-04)[2012-02-02]. http://www.fda.gov/ohrms/dockets/98fr/05d-0342-gdl0001.pdf.
13. 　孔祥亘, 韩绍磊, 郑昭敏, 等．高尔基体蛋白73联合甲胎蛋白异质体在原发性肝癌诊断中的价值[J]．山东大学学报(医学版)，2011, 49(4): 110．.
14. 　徐淑华. 血清AFP、CA19-9、CYFRA21-1联合检测对原发性肝癌的诊断价值[J]. 山东医药, 2010, 50(47): 55-56．.
15. 　青柳茔.肿瘤标志物的临床诊断意义及展望—甲胎蛋白(AFP)L3组分[J]. 日本医学介绍, 2005, 26(2): 49-50.
16. 　Leerapu A, Suravarapu SV, Bida JP, et al. The utility of Lensculinaris agglutinin-reaclive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: evaluation in a United States referral population[J]. Clin Gastroenterol Hepatol, 2007, 5(2): 394-402.

West China Medical Journal

The Cinical Value of Alpha-fetoprotein-L3 Detected by Enzyme Linked Immunosorbent Assay in the Diagnosis of Primary Liver Cancer

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