395例肝病患者血清甲胎蛋白10年随访  

Ten-year follow-up of serum AFP for 395 liver disease patients

作　　者：顾生旺[1] 赵兵[1] 孙瑶瑶[1] 蒋兆荣[1] 王建国[1] 

机构地区：[1]解放军第八二医院感染科,江苏淮安223001

出　　处：《肝脏》2011年第3期213-215,共3页Chinese Hepatology

摘　　要：目的分析395例各型肝病（合并肝占位或AFP异常）血清AFP的分布特点和变化规律。方法用放射免疫法和化学发光法检测血清AFP、铁蛋白、透明质酸,荧光定量PCR检测HBV DNA,全自动生化分析仪检测肝功能。定期复查和随访。结果共430例患者符合标准,纳入研究。35例（8.2%）失访,获随访的395例中,血清AFP未查者占4.8%（19/395）,其中13例诊断肝癌,占68.4%;其他肿瘤1例,占5.2%;肝硬化和（或）肝占位5例,占26.4%;血清AFP正常者占13%（49/376）,其中22例诊断肝癌,占44.9%;其他肿瘤15例,占30.6%;肝硬化和（或）肝占位12例,占24.5%;血清AFP11.4~100μg/L者占18.1%（68/376）,其中25例诊断肝癌,占36.8%;其他肿瘤6例,占8.8%;肝硬化和（或）肝占位等37例,占54.4%;血清AFP100~400μg/L者占18.4%（69/376）,其中31例诊断肝癌,占44.9%;其他肿瘤2例,占2.9%;肝硬化和（或）肝占位等36例,占52.1%;血清AFP400~3 000μg/L以上者占50.5%（190/376）,其中165例诊断肝癌,占86.8%;其他肿瘤1例,占0.5%;肝硬化和（或）肝占位等24例,占12.6%;对161例患者血清AFP动态观察,肝癌主要表现为低浓度和高浓度上升型、持续高浓度型和波动型;肝硬化和（或）肝占位主要表现为低浓度或高浓度下降型。结论动态观察血清AFP浓度变化,配合血清AFP异质体、铁蛋白、AST/ALT、GGT和肝穿刺病理检查,有助于肝癌的临床诊断和疗效预后判断。Objective To analyze the characteristics of serum AFP in 395 cases of various liver diseases（complicated with hepatic mass or abnormal AFP）.Methods Radioimmunoassay and chemiluminescence were used for detecting serum AFP,ferritin,hyaluronic acid,fluorescence quantitative PCR for HBV DNA,and automatic biochemical analyzer for liver function.All cases were follow-up regularly.Results Four hundred and thirty patients were included in the study.Three hundred and ninty-five cases were finished follow-up.Among them serum AFP was not checked（19/395） accounting for 4.8%,of which 13 were diagnosed to be with liver cancer,being 68.4%;1 case with other tumor,5.2%;5 cases with cirrhosis and / or liver lesions,26.4%;normal serum AFP（49/376） accounted for 13%,of which 22 were diagnosed to be with liver cancer,44.9%;15 cases with other tumors,30.6%;12 cases with cirrhosis and / or liver lesions,24.5%;serum AFP 11.4-100 μg / L（68/376） accounted for 18.1%,of which 25 patients with diagnosis of liver cancer,accounting for 36.8%;6 cases with other tumor,8.8%;37 cases with cirrhosis and / or liver lesions and others,54.4%;serum AFP 100-400 μg /L（69/376） accounted for 18.4%,of which 31 were diagnosed to be with liver cancer,44.9%;2 cases with other tumors,accounting for 2.9%;36 cases with cirrhosis and / or liver lesions,accounting for 52.1%;serum AFP 400-3 000 μg / L or above（190/376） accounted for 50.5%,of which 165 cases of diagnosed cancer,accounting for 86.8%;1 case with other tumor,accounting for 0.5%;24 cases with cirrhosis and / or liver lesions,12.6%;161 cases＇ serum AFP was dynamically observed.Liver cancer,mainly manifested to be low and high concentration elevation,sustained high concentration type and volatility type;cirrhosis and / or liver lesions are mainly shown to be the decline of low concentration or high concentration type.Conclusion Dynamic changes of serum AFP concentration,with serum AFP heterogeneity,ferritin,AST / ALT,GGT,and liver biopsy pathology will help the clinical diagnosi

关 键 词：AFP AFP异质体 铁蛋白 诊断 

分 类 号：R575[医药卫生—消化系统]