两种肝癌标志物对原发性肝癌诊断意义的评价  

EVALUATION OF THE COMBINED ASSAY OF α-FETO PROTEIN AND γ-GLUTAMYL TRANSPEP-TIDAS ISOENZYME II IN THE DIAGNOSIS OF PRIMARY HEPATIC CARCINOMA

作　　者：丁松泽[1] 李怀斌[1] 孙淑芳[1] 黄河[1] 陈振侬[1] 周展骥[1] 谭维中[1] 

机构地区：[1]河南省人民医院内科,广西医科大学附属第一医院内科

出　　处：《中华内科杂志》1995年第10期690-692,共3页Chinese Journal of Internal Medicine

摘　　要：为判断肝癌标志物对原发性肝癌诊断的意义，对１９７例良、恶性肝病、恶性胃肠道肿瘤病人及５１例正常人进行了γ－谷氨酰转肽酶同功酶ＩＩ（γ－ＧＴＰ－ＩＩ）、血清甲胎蛋白（ＡＦＰ）的检测，并对全部肝癌病人及４３例伴有ＡＦＰ升高的良性肝病病人进行了ＡＦＰ异质体分析。在１０４例原发性肝癌（ＰＨＣ）中，γ－ＧＴＰ－ＩＩ特异性最高（９５．７％），ＡＦＰ异质体的敏感性最好（８４．６％），其各自的阳性率在ＡＦＰ≥４００μｇ／Ｌ组及ＡＦＰ＜４００μｇ／Ｌ组差异均无显著性；在血清ＡＦＰ浓度不同时，两者各自的阳性率亦未见差异（Ｐ＞０．０５）；两者联合检测，共检出１０４例ＰＨＣ中的９７例（９３．３％），阳性率在ＡＦＰ≥４００μｇ／Ｌ组为９５．２％，在ＡＦＰ＜４００μｇ／Ｌ组为９１．９％。结果提示：γ－ＧＴＰ－ＩＩ和ＡＦＰ异质体联合检测能提高ＰＨＣ病人的检出率，对ＡＦＰ低浓度升高的ＰＨＣ患者同样有较好的诊断价值，可部分弥补单项检测ＡＦＰ的不足。有助于ＰＨＣ病人的及早诊断。erum α-feto protein (AFP)and γ-glutamyl transpeptidase isoenzyme II(γ-GTP-II) were assayed in104 patients with primary hepatic carcinoma(PHC).γ-GTP-II had a higher specificity of 95.7%,whileAFP a higher sensitivity of 84.6%. There was no significant difference in the positive diagnostic rate ofthe two markers in patients with AFP≥400μg/L and with AFP<400μg/L,Nor was there any differenceif the patients were divided into four groups according to the serum AFP levels of 200μg/L,400μg/L and1000μg/L,Altogether 97 of the 104 PHC patients were detected when the two markers were assaved incombination(40 out of 42 PHC patients with AFP≥400μg/L and 57 out of 62 PHC patients with AFP<400μg/L).These results suggest that combined assay of the two serum PHC markers will increase the de-tecting rate of PHC and be of value especially in those patients with normal or low serum level of AFP

关 键 词：甲胎蛋白 谷氨酰转移酶类 肝肿瘤 诊断 

分 类 号：R735.704[医药卫生—肿瘤] R730.43[医药卫生—临床医学]