酶联免疫吸附试验检测甲胎蛋白异质体对原发性肝癌的诊断价值  

The Cinical Value of Alpha-fetoprotein-L3 Detected by Enzyme Linked Immunosorbent Assay in the Diagnosis of Primary Liver Cancer

作　　者：韩素桂[1] 黄彩云[1] 刘洪梅[1] 李国安[1] 周秀艳[1] 李士龙[1] 

机构地区：[1]唐山市人民医院核医学检验科,河北唐山063001

出　　处：《华西医学》2012年第6期874-876,共3页West China Medical Journal

摘　　要：目的探讨酶联免疫吸附试验(ELISA)检测血清甲胎蛋白异质体(AFP-L3)含量对原发性肝癌(PLC)的诊断价值。方法选择2011年3月-11月门诊或住院的137例患者临床检测甲胎蛋白(AFP)为阳性的肝病患者血清,应用上海逸峰生物科技有限公司提供的ELISA法AFP-L3检测试剂盒检测AFP-L3浓度,137例中男98例,女39例,年龄28～77岁。其中PLC 92例,良性肝病45例,后者包括肝硬化37例、慢性肝炎8例。分析PLC组与良性肝病组AFP-L3浓度差异,运用受试者工作特征曲线(ROC)分析AFP-L3含量在PLC鉴别诊断中的价值。结果 PLC组AFP-L3浓度[(109.04±62.51)ng/mL]明显高于良性肝病组[(25.96±49.43)ng/mL,两组差异有统计学意义(t=8.28,P<0.001)。ROC分析结果显示,曲线下面积为0.819,以AFP-L3浓度37.89 ng/mL为临界值,分析92例PLC患者与45例良性肝病患者AFP-L3浓度异常的灵敏度为83.69%,特异度为88.88%,阳性预测值为93.90%(77/82),阴性预测值为72.72%(40/55),诊断准确度为85.40%。结论应用简便快速的ELISA法检测AFP-L3浓度在PLC与良性肝病鉴别诊断中具有较高的临床价值,便于临床推广。Objective To explore the clinical value of alpha-fetoprotein （AFP）-L3 detected by enzyme linked immunosorbent assay （ELISA） in the diagnosis of primary liver cancer （PLC）. Methods The serum samples of 137 patients with positive AFP treated in our hospital between March and November 2011 were studied. AFP-L3 ELISA detection reagent kit provided by Shanghai Yifeng Biotechnology Limited Company was used to detect AFP-L3 concentration. Among the patients, there were 98 males and 39 females aged between 28 and 77 years old. Ninety-two patients had PLC, and 45 had benign liver diseases among whom 37 had liver cirrhosis and 8 had chronic hepatitis. We analyzed the difference of AFP-L3 concentration between the PLC patients and patients with benign liver diseases. The receiver-operating characteristic curve （ROC） was used to analyze the value of AFP-L3 content on PLC diagnosis. Results The average level of AFP-L3 concentration in the patients with PLC was （109.04± 62.51） ng/mL which was significantly higher than those with benign liver diseases [（25.96±49.43） ng/mL] （t=8.28, P 〈 0.001）. The area under the ROC curve of AFP-L3 level was 0.819. Taking AFP-L3 level I〉 37.89 ng/mL as diagnostic criteria, the sensitivity of AFP-L3 level in PLC diagnosis was 83.69% and the specificity was 88.88%. DI（＋） was 93.90% （77/82）, and DI（-） was 72.72% （40/55）. The total conformity rate was 85.40% when compared with the confirmed clinical diagnosis. Conclusion ELISA has a high clinical value in detecting AFP-L3 which is a valuable biomarker in the diagnosis and prediction of prognosis of PLC.

关 键 词：甲胎蛋白 原发性肝细胞癌 甲胎蛋白异质体 酶联免疫吸附试验 

分 类 号：R735.7[医药卫生—肿瘤]