血清凝集素变化指导肝癌早期诊断的可行性研究  

Feasibility study of the changes of serum lectin in guiding early diagnosis of liver cancer

作　　者：李荣江[1] 黄建英 张磊 曾宪成 

机构地区：[1]深圳市宝安区西乡人民医院普外科,广东深圳518100 [2]增城市人民医院临床实验室,广东增城511300 [3]增城市人民医院普外科,广东增城511300

出　　处：《中国临床药理学杂志》2015年第19期1907-1909,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探析血清蛋白标记物早期诊断肝癌可行性及临床应用价值。方法入选60例肝癌患者(A组)、35例肝硬化患者(B组)、15例其他疾病(C组)、15例健康者(对照组)为研究对象,采集静脉血检测甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体膜蛋白73(CP73),并分析其和肿瘤直径、巴萨罗那(BCLC)分级相关性。结果 A组血清中AFP、AFP-L3、GP73含量均明显高于其余3组(P<0.05)。肿瘤直径和血清AFP和GP73水平无明显相关性,和血清AFP-L3存在明显相关性;肿瘤数量和血清AFP、AFP-L3、CP73无明显相关性。BCLC分级和AFP、AFP-L3呈正相关,AFP敏感度为85.7%,特异度为72.9%;AFP-L3敏感度为58.0%,特异度为87.6%;GP73敏感度为69.7%,特异度为76.7%。平行试验联合检测法可提高检测的敏感性及阴性预值;系列试验联合检测法提高特异性和阳性预测值。结论血清AFP、AFP-L3、CP73联合检测,利用阳性互补性,可明显提高肝癌诊断准确性。Objective To study the feasibility and clinical value of serum protein markers for early diagnosis of liver cancer. Methods A total of 60 patients with hepatocellular carcinoma（ A group）,35 patients with liver cirrhosis（ B group）, 15 patients with other diseases（ C group）,15 healthy persons（ control group） were selected for the study. Venous blood was collected to detect alpha- fetoprotein（ AFP）,AFP heterogeneity（ AFP- L3）,Golgi membrance protein 73（ CP73）,the correlation of tumor size and BCLC classification was analyzed.Results The serum AFP,AFP- L3,GP73 levels in group A were significantly higher than those in other three groups（ P〈0. 05）. There was no significant correlation between tumor size and serum levels of AFP and GP73,and there was significant correlation between tumor size and serum AFP- L3; no significant correlation between the number of tumors and serum AFP,AFP- L3,CP73. There was a positive correlation between BCLC classification and AFP,AFP- L3,the sensitivity of AFP was85. 7%, specificity was 72. 9%; the sensitivity of AFP- L3 was58. 0%,specificity was 87. 6%; the sensitivity of GP73 was 69. 7%,specificity was 76. 7%. Parallel test joint detection method can improve the sensitivity and negative predictive value of detection; series of tests combined detection method can improve the specificity and positivepredictive value. Conclusion Serum AFP,AFP- L3,CP73 joint detection and using positive complementary can significantly improve the accuracy of hepatic tumors diagnosis.

关 键 词：血清蛋白 血清甲胎蛋白 甲胎蛋白异质体 高尔基体膜蛋白73 肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R730.3[医药卫生—临床医学]