α-L-岩藻糖苷酶对原发性肝癌诊断价值的探讨

探讨α－L－岩藻糖苷酶（alpha-L-fucosidase AFU)对原发性肝癌的诊断价值。分别采用放免法和显色多肽基质法对93例原发性肝癌、45例恶性肿瘤，98例良性肝病、46名孕产妇及20例正常健康人的血清中甲胎蛋白（alpha-fetoprotein AFP)水平和AFU活性进行联合检测。原发性肝癌组血清AFP水平及AFU活性明显高于其它各疾病组。AFU和AFP对原发性肝癌诊断的敏感性分别为76．3％和74．2％，在AFP阴性肝癌患者中AFU阳性率为75．0％。AFU，AFP两者联合检测诊断原发性肝癌的敏感性可提高到93．5％。     

多种肿瘤标志物对发性肝癌的诊断价值

目的：探讨血清甲胎蛋白（AFP）、α－L－岩藻糖苷酶（AFU）、r-谷氨酰转肽酶（GGT）、血清糖抗原19－9（CA19－9）对原发性肝癌的诊断价值。方法对59例原发性肝癌（PHC）、47例良性肝病及41名正常人进行AFP、AFU、GGT、CA19－9的同步测定和对照。结果：AFP、AFU、GGT、CA19－9对PHC诊断的敏感性依次为76．3％、84．7％、66．1％和67．8％,特异性为85．2％、88．6％、56．8％和80．6％。联合检测对PHC诊断的敏感性可提高为94．9％。结论多种肿瘤标志物联合检测对诊断PHC具有重要价值。     

AFP、AFU和SA联合检测在肝细胞癌诊断中的价值

目的探索检测AFP、AFU、SA三种血清学指标以提高对肝细胞癌(HCC)检查的敏感性。方法对肝细胞癌患者50例,良性肝病患者50例,健康体检者62例进行3种血清学指标检测。结果肝细胞癌组3项指标与良性肝病组比较均有显著性差异(P<0.01~0.05)。肝细胞癌组单项AFP、AFU、SA阳性检出率分别是66%、78%、72%,3项联合检测敏感性达96%。结论联合测定血清AFP、AFU、SA可提高肝细胞癌的血清学诊断灵敏度。     

检测血清α-L-岩藻糖苷酶对原发性肝癌的诊断意义

应用ELISA法检测了54例原发性肝癌和其他肝病患者血清α-L-岩藻糖苷酶(AFU)水平。结果显示原发性肝癌患者血清AFU浓度显著高于其他疾病组和对照组(P<0.01)。AFU对原发性肝癌的诊断敏感性为74.1％,特异性为98.8％,准确度为88.9％,且AFU水平与甲胎蛋白(AFP)及肝癌直径大小之间无相关性,提示血清AFU检测对原发性肝癌的诊断及鉴别诊断有一定价值,尤其对AFP阴性肝癌及小肝癌具有更重要的意义。     

联合检测血清α-L-岩藻糖苷酶、甲胎蛋白对原发性肝癌患者的临床意义

探讨血清α-L-岩藻糖苷酶(AFU)和甲胎蛋白(AFP)的联合检测对原发性肝癌(PHC)诊断的临床意义.应用自动生化分析仪测定正常人,非PHC的其它恶性肿瘤组,PHC组患者血清AFU的含量,应用时间分辨荧光免疫分析测定血清AFP含量.PHC、肝转移癌、胰腺癌均高于正常对照组(P＜0.01或P＜0.05),PHC阳性率高90.9%.AFU与AFP之间无相关性(P＞0.5).血清AFU在PHC中敏感性较高.联合检测AFU、AFP对明显提高PHC的诊断具有实用价值.     

AFU、AFP、GGT、GPDA联合检测在原发性肝癌诊断中的价值

目的探讨α-L岩藻糖苷酶（AFU）、甲胎球蛋白（AFP）、谷氨酰氨基转移酶（GGT）、甘氨酰脯氨酸二肽氨基肽酶（GPDA）联合检测在原发性肝癌（PHC）诊断中的价值，提高PHC诊断的准确性。方法AFP采用酶联免疫法；AFU、GPDA采用酶法；GGT采用速率法。分别测定原发性肝癌组、良性肝病组、健康对照组各项目结果均采用统计学分析。结果原发性肝癌组AFU、AFP、GPDA与良性肝病组和正常对照组均差异有显著性（P＜0．05），良性肝病组AFU、GGT与正常对照组比较差异有显著性（P＜0．05）。结论AFU、AFP、GGT、GPDA联合检测可以明显提高对原发性肝癌诊断的准确性。     

血清AFP联合GP73在原发性肝癌的诊断中的意义

目的探讨甲胎蛋白（AFP）和高尔基体糖蛋白-73（GP73）在原发性肝癌患者和健康者血清中的水平及其诊断价值。方法回顾性分析原发性肝癌患者的类型及可能的危险因素,采用电化学发光法及酶联免疫法（ELISA）分别对37例肝癌患者和38例健康体验者进行血清AFP及GP73的含量检测,分析AFP、GP73及AFP＋GP73在肝癌诊断中的敏感性和特异性。结果 37例原发性肝癌患者中,34例（91.89%）为肝细胞癌,28例（75.68%）有病毒性肝炎病史。肝癌患者血清中AFP和GP73的含量分别为（418.31±189.93）ng/ml和（252.03±238.34）ng/ml,显著高于对照组的（16.28±9.39）ng/ml和（34.03±22.67）ng/ml,均P〈0.01。AFP和GP73联合检测肝癌的敏感性及特异性可达86.49%和84.20%,与单项检测相比,可明显提高诊断的准确性。结论血清中AFP及GP73含量是原发性肝癌发生、发展的重要检测指标,二者联合检测对肝癌患者诊断具有重要意义。     

肝癌患者血清AFP、AFU和SHCSP的联合检测

为探讨多种肝癌标志物联合检测对原发性肝癌的临床诊断价值。对79例经B超、计算机断层扫描(CT)诊断为肝癌的患者进行了甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)和特异性肝癌蛋白(SHCSP)的联合检测。单项AFP、AFU和SHCSP法在PHC组的阳性检出率分别为75．95％、72．15％及70．89％，AFP法与AFU法两项联检阳性率为91．14％，AFP法与SHCSP法两项联检，阳性率为89．87％，三项联检的阳性率97．47％，均显著高于任何单项检测的阳性率(χ^2＝15．87，P＜0．005)。AFU法和SHCSP法在19例AFP阴性的PHC病例中，阳性检出率分别为73．6％和68．42％。采用多种肿瘤标志物联合检测，可明显提高肝癌患者的诊断率，对肝癌的早期诊断，尤其对AFP阴性的肝癌诊断具有更重要的临床应用价值。     

联合检测血清AFP、AFU和ALP对原发性肝癌诊断的价值

目的探讨肿瘤标志物甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)和碱性磷酸酶(ALP)对原发性肝癌(PHC)联合检测的诊断价值。方法收集本院消化内科2014年2月至2016年2月期间住院的67例PHC患者、56例良性肝病以及同期60例健康体检者血清,常规方法检测其血清AFP、AFU和ALP含量。分析联合检测AFP、AFU、ALP对PHC的诊断价值。结果 PHC组的AFP平均水平为(328.6±198.5)ng/mL、AFU为(68.3±7.4)U/L、ALP为(256.3±77.2)U/L,明显高于良性肝病组和对照组,差异有统计学意义(P0.05)。对于PHC患者,AFP、AFU和ALP的检测阳性率分别为67.16%、73.13%和71.64%,其中AFU的敏感度最高,而AFP的特异度最高,3项指标联合检测其敏感度可达88.06%,阴性预测值提高至89.74%。结论联合检测血清AFP、AFU和ALP可以提高PHC诊断敏感度,对于PHC的诊断和病情监测具有较大的临床价值。     

血清甲胎蛋白异质体对肝细胞癌的诊断意义

目的探讨甲胎蛋白异质体（AFP-L3）对肝细胞癌的诊断意义。方法采用电化学发光法和亲和吸附离心管法检测135例肝细胞癌和116例慢性肝炎和肝硬化患者血清AFP和AFP-L3。结果肝细胞癌患者血清AFP和AFP-L3阳性率明显高于良性肝病患者,差别有统计学意义（P〈0.001）;血清AFP-L3阳性与肿瘤大小无相关性（P〉0.05）。结论甲胎蛋白异质体在肝细胞癌的诊断中具有重要的价值。     

Value of circulating cell-free DNA in diagnosis of hepatocelluar carcinoma

AIM:To investigate the value of combined detection of circulating cell-free DNA(cfDNA),a-fetal protein(AFP) and a L-fucosidase(AFU) for diagnosis of hepatocellular carcinoma(HCC).METHODS:Serum samples from 39 HCC patients and 45 normal controls were collected.Branched DNA(bDNA) was used to detect the level of cfDNA,and a receiver operating characteristic curve was employed to evaluate the diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden index,and to assess the diagnostic efficiency and their correlations with the clinicopathological features.AFP and AFU were detected by chemiluminescence and colorimetry,respectively.The significance of combined detection of the three biomarkers was discussed.RESULTS:cfDNA level was increased in 22 of the 39 HCC samples and in 2 of the 45 normal controls.cfDNA level in HCC samples was significantly higher than that in normal controls(P < 0.05).There were significant differences in sex and extra-and intrahepatic metastasis(P < 0.05).There was no significant correlation between cfDNA,AFP and AFU in the detection of HCC.The sensitivity of combined detection of cfDNA with one marker(AFP or AFU) and cfDNA with two markers(AFP and AFU) was 71.8%,87.2% and 89.7% vs 56.4%,53.8% and 66.7% for cfDNA,AFP and AFU used alone,respectively,the difference being statistically significant(P < 0.05).CONCLUSION:Quantitative analysis of cfDNA is sensitive and feasible,and the combined detection of cfDNA with AFP or AFU or both could improve the diagnostic sensitivity for HCC.     

血清标志物在肝炎肝硬化患者中诊断肝癌的价值

目的寻找有效的适合用于肝炎肝硬化患者肝癌诊断的血清肿瘤标志物.方法AFP测定应用竞争性放射免疫技术(RIA),岩藻糖苷酶(AFU)测定应用酶化学技术,唾液酶(SA)测定应用化学法,可溶性白介素2受体(sIL-2R)和肝细胞生长因子(HGF)的测定应用单克隆抗体双夹心酶联免疫吸附试验(ELISA).结果AFU、AFP和SA三项指标肝癌患者显著高于肝硬化患者,P值分别为P=0.027,P＜0.001和P＜0.001.分别以AFU值440nmol/ml·h-1、AFP测定值400 ng/ml、SA测定值590 μg/ml为阳性参考值,测定肝癌组患者阳性率分别为57.57%、68.09%和35.7%.三者假阳性率分别为48%、20%和0,以AFP和SA对41例肝癌进行联合检测,其肝癌患者阳性检出率为80.49%.肝癌患者血清sIL-2R水平与肝硬化患者及肝炎患者比较无显著差异,P＞0.05.肝癌患者血清HGF水平低于肝硬化患者以及重症肝炎患者.结论肝癌患者HGF、sIL-2R和AFU显著高于正常人血清,但其升高的水平受肝脏炎症影响较大,对肝癌的特异性较差,因而不适合应用于肝炎肝硬化患者肝癌的诊断.AFP仍然是最敏感的肝癌血清指标,SA具有肿瘤特异性高和不受肝脏炎症干扰的特点,适合肝炎肝硬化患者肝癌的诊断,联合AFP可以使阳性检出率达80.49%,使肝癌的诊断灵敏性大大提高.     

联检肝癌标志物对高危人群早期肝癌筛查的临床价值

目的 探讨联合检测肝癌标志物对肝癌高危人群早期肝癌的诊断价值。方法 从住院及体检中抽取1000例HBsAg阳性的乙型肝炎患者，随机分为联检组（300例）和对照组（700例）。联检组每半年检测1次血清AFP、AFU、GGT—Ⅱ、TSGF，阳性患者追加检测次数同时进行影像学检查；对照组则不定期检测上述肝癌标志物和定期电话随访。结果 联检组5年共检出早期肝癌4例，均为小肝癌。对照组5年发现肝癌8例，无1例早期肝癌病例。结论 应用AFP、APU、GGT—Ⅱ、TSGF肿瘤标志物联合检测可明显提高肝癌的早期诊断，尤其对高危人群意义更大。     

Diagnostic significance of the determination of serum alpha-L-fucosidase in primary hepatocellular carcinoma

The results of determination of serum alpha-L-fucosidase (AFU) in healthy individuals, in patients with various liver diseases and non-liver malignant diseases were reported. In primary hepatic carcinoma the level of serum AFU was significantly higher than that in various other diseases and healthy persons (P less than 0.001). The serum AFU level was independent of AFP level (x = 1.24, P greater than 0.25). These data suggest that AFU may be a useful marker for the diagnosis of primary hepato cellular carcinoam with negative AFP.     

血清高尔基蛋白73、甲胎蛋白异质体3、甲胎蛋白和α-L-岩藻糖苷酶水平诊断原发性肝癌的效能分析*

目的 探讨应用血清高尔基蛋白体73（GP73）、甲胎蛋白异质体3（AFP-L3）、AFP和α-L-岩藻糖苷酶（AFU）水平诊断原发性肝癌（PLC）患者的效能。方法 2015年1月~2017年3月我院诊治的PLC患者261例,乙型肝炎肝硬化患者201例,慢性乙型肝炎患者238例和体检健康人200例,采用酶联免疫吸附试验法检测血清GP73水平,采用亲和吸附离心管法检测血清AFP-L3,采用全自动化学发光仪检测血清AFP,采用商用试剂盒检测血清AFU水平。绘制血清GP73、AFP-L3、AFP和AFU诊断PLC的ROC曲线,确定截断点（cut-off-value）,计算ROC曲线下面积（AUC）,判断它们的诊断效能。结果 肝癌组血清GP73水平显著低于慢性肝炎组和肝硬化组,差异有统计学意义（P<0.05）,血清AFP-L3显著高于其他3组,差异有统计学意义（P<0.05）,血清AFU水平显著高于健康人和肝硬化组,但低于慢性肝炎组,差异有统计学意义（P<0.05）;以非肝癌人群为对照,血清GP73、AFP-L3、AFP和AFU诊断肝癌的ROC曲线下面积分别为0.564（95%CI：0.485~0.636）、0.724（95%CI：0.555~0.786）、0.745（95%CI：0.654~0.806）和0.571（95%CI：0.385~0.536）,血清AFP-L3联合AFP诊断肝癌的截断点分别为8.25%和49.25 ng/ml,其灵敏度（Se）为55.5%,特异度（Sp）为85.0%,正确性（Ac）为80.1%,显著高于血清AFP-L3诊断的55.5%、85.0%和76.4%或AFP诊断的57.1%、82.7%和75.2%（P<0.05）;在261例肝癌患者中,血清AFP<9.6 ng/ml者71例（27.2%),其中PG73>106.5 ng/ml者30例（42.3%）,提示GP73对AFP阴性肝癌有一定的诊断价值;在201例肝硬化患者中,血清AFP<9.6 ng/ml者98例（48.8%）,其中PG73>106.5 ng/ml者52例（53.1%）,提示血清GP73水平容易受到肝硬化的影响。结论 应用血清AFP联合AFP-L3检测能够提高诊断肝癌的效能,但它们的灵敏度都还不够高,影响因素较多。临床医生需结合病史、影像学检查和动态血清学检测才能做出更为科学的结论。     

Alpha-L-fucosidase as a serum marker of hepatocellular carcinoma in Thailand

To evaluate the role of serum alpha-L-fucosidase (AFU) in the diagnosis of hepatocellular carcinoma (HCC), we simultaneously studied both AFU activity and alpha-fetoprotein (AFP) level in 60 patients with HCC, 60 patients with cirrhosis and chronic hepatitis each, 30 patients with other liver tumors and 60 healthy subjects. Serum AFU activity in patients with HCC (1,418.62 +/- 575.76 nmol/ml/hr) was significantly higher than that found in cirrhosis (831.25 +/- 261.13 nmol/ml/hr), chronic hepatitis (717.71 +/- 205.86 nmol/ ml/hr) or other tumors (706.68 +/- 197.67 nmol/ml/hr) and in controls (504.18 +/- 121.88 nmol/ml/hr, p < 0.05). With 870 nmol/ml/hr (mean value of controls plus 3 standard deviations) considered as the cut-off point, AFU was more sensitive (81.7 vs 39.1%) but less specific (70.7 vs 99.3%) than AFP at a level of > 400 ng/ml as a tumor marker of HCC. With both markers combined, the sensitivity was improved to as much as 82.6%. AFU activity in HCC patients was correlated to tumor size (r = 0.3529, p = 0.006) but not associated with tumor staging classified by Okuda's criteria (p = 0.1). The AFU activity in the viral hepatitis group (hepatitis B or C) was also significantly higher than in the non-viral group (p = 0.0005). We conclude AFU to be a useful marker, in conjunction with AFP and ultrasonography, for detecting HCC, particularly in patients with underlying viral hepatitis and cirrhosis.     

A preliminary study on serum alpha-L-fucosidase assay in the diagnosis of hepatocellular carcinoma

Serum alpha-L-fucosidase (AFU) was determined in 33 patients with hepatocellular carcinoma (HCC), 4 with secondary metastatic liver cancer, 61 with various liver diseases, 12 with gastrointestinal tumor and 50 healthy controls. The results showed that AFU level was significantly higher in HCC (14.48 +/- 5.77) than that in the controls (3.33 +/- 0.72) and in patient with other diseases (P less than 0.01). Serum AFU level was also increased in fulminant hepatitis (8.96 +/- 3.99), acute hepatitis (8.94 +/- 4.94) and chronic hepatitis (7.27 +/- 2.58), P less than 0.01 or 0.05. There was no significant difference in AFU level between the controls and patients with secondary metastatic liver cancer (6.25 +/- 0.84), cirrhosis (6.30 +/- 3.17), gastrointestinal tumor (4.43 +/- 1.64), liver hemangioma and liver abscess (4.86 +/- 2.22). A level exceeding 10.5u was a useful marker for the diagnosis of HCC with 78.8% sensitivity and 90.0% specificity. The diagnostic positivity was 81.8% in low AFP producing HCC, whereas 93.9% in those with elevated AFP. Our data indicate that serum AFU is a useful tumor marker for HCC, particularly in detection of AFP-low or negative HCC patients.