3种血清肿瘤标志物检测在原发性肝癌诊断中价值  

Value of three serum tumor markers to the diagnosis of primary hepatocellular carcinoma

作　　者：王莉[1] 贾志凌[1] 刘畅[1] 柴丽娜[1] 

机构地区：[1]北京军区总医院肿瘤科,北京100700

出　　处：《中华实用诊断与治疗杂志》2013年第8期759-761,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨血清甲胎蛋白(alpha-fetoprotein,AFP)、甲胎蛋白异质体(lectin-reactive alpha-fetoprotein,AFP-L3)及高尔基体糖蛋白73(Golgi protein 73,GP73)检测诊断原发性肝癌的价值。方法 102例原发性肝癌患者(肝癌组),79例良性肝病患者(良性肝病组)和体检健康者31例(对照组),采用电化学发光法检测3组AFP,AFP阳性者(>20μg/L)采用亲和吸附离心管法检测AFP-L3,采用酶联免疫法检测GP73。结果 AFP、AFP-L3和GP73对原发性肝癌诊断的灵敏度分别为51.96%、75.50%、77.45%,特异性分别为50.63%、93.67%、71.95%;三者联合检测对原发性肝癌诊断的敏感性为95.10%,特异性为93.67%;AFP>400ng/mL组AFP-L3阳性率(96.23%)与≤400ng/mL组(53.06%)比较差异有统计学意义(P<0.05),GP73阳性率(75.47%)与≤400ng/mL组(75.51%)比较差异无统计学意义(P>0.05)。结论 AFP、AFP-L3及GP73联合检测可提高原发性肝癌诊断的敏感性及特异性;GP73诊断早期原发性肝癌优于AFP。Objective To investigate the diagnostic value of alpha-fetoprotein （AFP）, lectin-reactive alpba-fetoprotein （AFP-L3） and Golgi protein 73 （GP73） to the diagnosis of primary hepatocellular carcinoma. Methods Serum AFP was detected by using electrochemiluminescence assay in 102 patients with primary hepatoeelluiar carcinoma, 79 patients with benign liver diseases and 31 healthy volunteers. AFP-L3 was detected by using affinitive centrifugal tube in patients with positive AFP （〉20 μg/L）. GP73 was quantitatively analyzed by using ELISA. Results The sensitivities of AFP, AFP- L3 and GP73 were 51.96%, 75.50% and 77. 450/00, and the specificities were 50.63%, 93. 67% and 71.95% respectively in the diagnosis of primary hepatocellular carcinoma. The sensitivity and specificity of the combined detection of three markers were 95. 10% and 93. 67% in the diagnosis of hepatocellular carcinoma. The positive rate of AFP-L3 was 96.23% in patients with AFP%400 ng/mL, obviously higher than that in those with AFP%400 ng/mL （53.06%） （P〈 0.05）, and there was no significant difference in the positive rate of GP73 between them （75.47% vs 75. 51%） （P〉 0.05）. Conclusion The combined detection of AFP, AFP-L3 and GP73 can improve the sensitivity and specificity in the diagnosis of primary hepatocellular carcinoma. GP73 is superior to AFP in the early diagnosis of primary hepatocellular carcinoma.

关 键 词：肝癌 甲胎蛋白 甲胎蛋白异质体 高尔基体蛋白73 

分 类 号：R735.7[医药卫生—肿瘤]