甲胎蛋白异质体对诊断肝细胞癌的相关价值研究

目的评价甲胎蛋白异质体(AFP-L3)对于原发性肝癌(PHC)的诊断价值。方法收集本院2013年1月至2013年7月住院及门诊患者185例,包括PHC患者61例(PHC组)、肝硬化患者66例(肝硬化组)、慢性活动性肝炎患者58例(慢性肝炎组)。选择同期健康体检者60例为对照组。AFP-L3采用亲和吸附离心管分离血清,AFP和AFP-L3水平采用化学发光法检测,以AFP-L3≥10%为阳性诊断标准,计算AFP-L3的百分含量。结果 PHC组、肝硬化组、慢性肝炎组、对照组患者血清AFP-L3阳性率分别为78.02%、69.8%、78.26%、0%。PHC组患者AFP-L3水平与肝硬化组比较,差异无统计学意义(P=0.062)。PHC组患者AFP-L3水平与对照组比较,差异有统计学意义(P=0.031)。结论AFP-L3是国际公认的对PHC鉴别诊断的有用指标,但本研究显示其在良性肝病特别是肝硬化与PHC差别不明显,因此仍应与AFP及影像学联合检测更有利于PHC的诊断。

Value of alpha-fetoprotein for diagnosis of primary hepatocellular carcinoma

objective To evaluate the value of AFP different isoforms （AFP-L3） for the diagnosis of primary hepatic carcinoma （PHC）. Methods Total of 185 patients from January 2013 to July 2013 included 61 patients with primary hepatocellular carcinoma （PHC group）, 66 patients with cirrhosis of the liver （liver cirrhosis group） and 58 patients with chronic active hepatitis （chronic hepatitis group） was recruited. Control group has 60 patients of the the corresponding time period healthy physical examination controls. AFP-L3 was detected using afifnity adsorption centrifugal tube separation, serum AFP and AFP-L3 levels by was detected using chemiluminescence detection, AFP-L3 10%or more was regarded as positive for diagnostic criteria, the percentage content of AFP-L3 was calculated. Results The serum AFP-L3 positive rate of PHC group, liver cirrhosis group, chronic hepatitis group and control group were 78.02%, 69.8%, 78.26%and 0%, respectively. The difference between AFP-L3 levels of PHC group and that of liver cirrhosis group was not signiifcant （P= 0.062）. AFP-L3 level of PHC group was signiifcantly higher than that of control group （P= 0.031）. Conclusions AFP-L3 is internationally recognized as useful indicators to differential diagnosis of PHC, but this study shows that in the benign liver diseases, especially in liver cirrhosis with PHC difference is not signiifcant, so the AFP and imaging detection is more advantageous to the diagnosis of PHC.