HS-AFP GGT-Ⅱ及AFP预测肝硬化癌变的临床价值  

The Value of HS-AFP, GGT- II and AFP in Predicting Hepatocarcinogenesis in Patients with Liver Cirrhosis

作　　者：赵敏星[1] 倪润洲[1] 肖明兵[1] 江枫[1] 陆翠华[1] 魏群[1] 李峰[1] 

机构地区：[1]南通大学附属医院消化内科,江苏省南通市226001

出　　处：《中国肿瘤临床》2009年第11期601-604,共4页Chinese Journal of Clinical Oncology

基　　金：江苏省社会发展科技指导性计划(编号:BS2004528);江苏省卫生厅科研项目资助(编号:H200521)

摘　　要：目的:探讨肝癌特异性甲胎蛋白(HS-AFP)、甲胎蛋白(AFP)和γ-谷氨酰转肽酶同工酶Ⅱ(GGT一Ⅱ)对肝硬化患者肝癌发生风险的预警价值。方法:HS-AFP采用聚丙烯酰胺凝胶电泳技术(PAGE)结合Western blot分离检测。AFP采用放射免疫分析测定法。GGT-Ⅱ采用PAGE分离检测。对341例肝硬化患者进行跟踪随访18个月,了解肝癌发生情况,分析比较HS-AFP、GGT-Ⅱ和AFP预测肝硬化患者发生肝癌风险的价值。结果:6、12、18个月随访期内HS-AFP、GGT-Ⅱ两项指标阳性组癌变率高于阴性对照组;随访12个月以上AFP阳性组癌变率高于阴性对照组;Hs-AFP、GGT-Ⅱ阳性组癌变率高于AFP阳性组,但前两者差异不明显;HS-AFP与GGT-Ⅱ及AFP之间存在互补性,其中HS-AFP和GGT-Ⅱ联合检测预测肝硬化癌变的敏感性、特异性和准确度分别达71.6%、91.4%、91.6%。结论:HS-AFP、GGT-Ⅱ和AFP对肝硬化癌变均有预测价值;HS-AFP和GGT-Ⅱ预测肝癌的特异性、准确度优于AFP;HS-AFP与GGT-Ⅱ预测肝癌的特异性、准确度相似;多项指标联合检测可提高预测肝硬化癌变的敏感性、特异性和准确度,以HS-AFP和GGT-Ⅱ联合检测效果最优。Objective： To evaluate the role of hepatoma-specific alpha-fetoprotein （HS-AFP）, alpha-fetoprotein （AFP） and gamma-glutamyltransferase isoenzyme Ⅱ （GGT-Ⅱ） in predicting the risk of hepatocarcinogenesis in patients with liver cirrhosis. Methods： The protein levels of HS-AFP, AFP and GGT-Ⅱ were tested in 341 patients with liver cirrhosis. Specifically, HS-AFP was separated with PAGE and detected with Western blot. AFP was detected with radioimmunoassay. GGT-Ⅱ was separated with PAGE. These 341 patients were followed up for 18 months. Statistical analyses were performed to explore the correlation between protein expression of the three tumor markers and hepatocarcinogenesis. Results： The hepatocarcinogenesis rates in patients with elevated HS-AFP and GGT-Ⅱ were higher than those in the patients without elevated HS-AFP and GGT-Ⅱ at the end of the follow-up period. Compared with the group of patients with elevated AFP, the patients with elevated HS-AFP or GGT-Ⅱ had higher hepatocarcinogenesis rates. There was no significant difference in hepatocarcinogenesis rates between the patients with elevated HS-AFP and those with elevated GGT-Ⅱ. The three markers were complementary in predicting hepatocarcinogenesis. The sensitivity, specificity and accuracy of combined detection of HS-AFP and GGT-Ⅱ were 71.6%, 91.4% and 91.6%, respectively. Conclusion： HS-AFP, GGT-Ⅱ and AFP are useful indices for the prediction of hepatocarcinogenesis in patients with liver cirrhosis. HS-AFP and GGT-Ⅱ are more valuable than AFP in predicting hepatocarcinogenesis, while the specificity and accuracy of HS-AFP and GGT-Ⅱ alone are similar. Combined detection of these markers increases the sensitivity, specificity and accuracy for the prediction of hepatocarcinogenesis, with the detection of HS-AFP and GGT-Ⅱ in combination providing the best results.

关 键 词：肝癌特异性甲胎蛋白 γ-谷氨酰转肽酶同工酶Ⅱ 甲胎蛋白肝硬化肝细胞肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R525[医药卫生—临床医学]