凝集素捕获微量离心柱法检测甲胎蛋白异质体在原发性肝癌中的应用评价  

Application evaluation of alpha-fetoprotein variant with lectin microcentrifugalcolumn method in the diagnosis of primary liver carcinoma

作　　者：季君[1] 顾星[1] 高致远[1] 孙小娟[1] 董桂玲[1] 周军[1] 陈建栋[1] 高春芳[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院实验诊断科,上海200438

出　　处：《检验医学》2011年第4期256-259,共4页Laboratory Medicine

摘　　要：目的探讨凝集素捕获微量离心柱法检测甲胎蛋白异质体(AFP-L3)在原发性肝癌(PLC)中的临床应用。方法采用电化学发光法(ECL)和凝集素捕获微量离心柱法分别定量检测622例甲胎蛋白(AFP)阳性PLC、24例AFP阴性PLC、17例AFP阳性良性肝脏疾病患者AFP-L3,并比较凝集素捕获微量离心柱法和凝集素亲和免疫电泳自显影法检测AFP-L3的符合率。结果 622例AFP阳性PLC患者中,AFP-L3阳性患者的γ-谷氨酰基转移酶(GGT)、总胆红素(TBil)明显高于AFP-L3阴性患者(P<0.05)。AFP-L3与患者的丙氨酸氨基转移酶(ALT)、白蛋白(Alb)均无相关性。凝集素捕获微量离心柱法和凝集素亲和免疫电泳自显影法检测AFP-L3的阳性率分别是46%、50%,两者的符合率为92%。按AFP浓度分层分析AFP-L3阳性率后发现,随AFP浓度升高,AFP-L3阳性呈现上升趋势。AFP-L3在AFP阳性的PLC患者和AFP阳性的良性肝脏疾病患者中的检出率分别为16.67%、23.53%,显著低于AFP阳性的PLC患者(63.5%,P<0.05)。结论凝集素捕获微量离心柱法与凝集素亲和免疫电泳自显影法具有较好的一致性;AFP-L3在AFP阳性的PLC患者中有较高的检出率,对临床具有辅助诊断和鉴别诊断价值。Objective To investigate the clinical application of lectin microcentrifugalcolumn method for the measurement of alpha-fetoprotein variant（AFP-L3） in primary liver carcinoma（PLC）.Methods Serum AFP-L3 in 622 AFP-positive PLC patients,24 AFP-negative PLC patients and 17 AFP-positive patients with benign liver disease were quantitatively detected by electrochemiluminescence（ECL） method and lectin microcentrifugalcolumn method.The coincidence of AFP-L3 between lectin microcentrifugalcolumn method and lectin affinity immunoelectrophoresis autoradiography method was compared.Results In 622 AFP-positive PLC patients,there was no association of AFP-L3 with their clinical and biochemical indicators such as alanine aminotransferase（ALT） and albumin（Alb）.In AFP-L3 positive group,the levels of gamma-glutamyltransferase（GGT） and total bilirubin（TBil）were much higher than those in AFP-L3 negative group（P0.05）.The AFP-L3 positive rates of lectin microcentrifugalcolumn method and lectin affinity immunoelectrophoresis autoradiography method were 46% and 50% respectively.The coincidence of the 2 methods was 92%.Stratified analysis by AFP concentration of AFP-L3 positive rate showed that the positive rate of AFP-L3 increased with the rising of AFP concentration.In AFP-negative PLC patients and AFP-positive patients with benign liver diseases,the AFP-L3 positive rates were 16.67% and 23.53% respectively,which were obviously lower than those of AFP-positive PLC patients（63.5%,P0.05）.Conclusions Lectin microcentrifugalcolumn method is consistent with lectin affinity immunoelectrophoresis autoradiography method.In AFP-positive PLC patients,the detection rate of AFP-L3 is higher,and AFP-L3 has a clinical value in the auxiliary diagnosis and differential diagnosis.

关 键 词：甲胎蛋白异质体 凝集素捕获微量离心柱法 原发性肝癌 诊断 

分 类 号：R446.62[医药卫生—诊断学]