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  

Detection of α-fetoprotein-L3 using agglutinin-coupled spin column to be used in diagnosis of hepatocellular carcinoma

作　　者：孙桂珍[1] 赵秀英[1] 李俊红[1] 赵国庆[1] 王绍祥[1] 孔淑玲[1] 

机构地区：[1]首都医科大学附属北京佑安医院临床检验中心,100069

出　　处：《中华医学杂志》2008年第28期1986-1988,共3页National Medical Journal of China

摘　　要：目的应用凝集素微量离心柱法（ACSC）检测甲胎蛋白异质体（AFP-L3），分析AFP-13在鉴别肝细胞癌（HCC）与良性肝脏病变中的价值。方法选择132例临床检测AFP为阳性的肝病患者血清。应用装有耦联了小扁豆凝集素（LCA）的微量离心柱分离、洗脱获得AFP-L3，采用配套试剂在美国雅培AXSYM酶免疫分析仪检测AFP以及AFP-L3含量，计算AFP-L3在AFP中的比例即AFP-L3％。结果以ACSC法分离AFP—13操作简便；HCC患者血清AFP-L3％异常升高，其均值明显高于良性肝病患者（P〈0．01）；根据AFP-L3％计算受试者工作曲线（ROC）曲线下面积为0．807。以AFP-L3％≥10％为临界值，分析79例HCC患者与53例良陛肝脏疾病患者，AFP-L3％异常的灵敏度为84、8％（67／79）；特异性为92．5％（49／53），与临床总体符合率为87．9％。结论应用ACSC辅助检测的AFP-L3在HCC与良性肝脏病变鉴别诊断中有一定临床价值。Objective To explore the effect of use of lens culinaris agglutinin （LCA）-coupled spin column （ACSC） in detection of α-fetoprotein （AFP） isoform AFP-L3 and to evaluate the value of AFP-L3 as a biomarker in diagnosis of hepatocellular-carcinoma （HCC）. Methods The serum samples of 132 patients with elevated AFP level （20 - 1000 μg/L）, 79 diagnosed as with HCC and 53 with benign liver diseases （35 with liver cirrhosis and 18 with chronic hepatitis） underwent ACSC to isolate the fraction of AFP-L3. The contents of AFP and AFP-L3 were detected Dy micro-particle immunoassay. The ratio of AFP- L3 to total AFP, AFP-L3%, was calculated. Correlation between the abnormally elevated AFP-L3% and HCC was analyzed. Results Detection of AFP-L3% using ACSC method was operating friendly. The average value of AFP-L3% in the patients with HCC was 36.4%, significantly higher than those of the patients with benign liver diseases （5.3% respectively, P 〈 0. 01 ）. The area under the receiver operating characteristic（ROC）curve of AFP-L3% was 0. 807. Taking AFP-L3% ≥ 10% as diagnostic criteria, the sensitivity of AFP-L3% in HCC diagnosis was 84. 8% （ 67/79 ） and the specificity was 92.5% （49/53）, with a total conformity rate of 87. 9% compared to the confirmed clinical diagnosis. Conclusion ACSC is of clinical value in detecting AFP-L3. AFP-L3% is a valuable biomarker in diagnosis and prediction of prognosis of HCC.

关 键 词：甲胎蛋白类 肝肿瘤 甲胎蛋白异质体 小扁豆凝集素 

分 类 号：R686[医药卫生—骨科学]