对甲胎蛋白异质体在诊断肝细胞癌中的价值评估  

The value of detectingα-Fetoprotein variants with a micro-spin column method in differential diagnosis of hepatocellular carcinoma and benign liver diseases

作　　者：程田[1] 刘献华[1] 张清萍[1] 唐振林[1] 宋文忠[1] 

机构地区：[1]四川省医学科学院.四川省人民医院核医学科,四川成都610072

出　　处：《中国实验诊断学》2017年第6期948-950,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的对甲胎蛋白异质体在诊断肝细胞癌中的价值进行评估。方法选择186例良性肝病和79例肝癌患者的血清。通过偶联了小扁豆凝集素(LCA)的微量离心柱分离、洗脱获得AFP-L3,应用化学发光微粒子免疫分析法检测AFP和AFP-L3水平,计算AFP-L3占AFP的百分比即AFP-L3%。结果肝细胞癌组血清AFP、AFP-L3和AFP-L3%均高于良性肝病组(P<0.01);两组患者的AFP-L3与AFP水平均呈正相关关系(r=0.729,P<0.01);而AFP-L3%与AFP水平均无相关关系(r=-0.125,P>0.05);AFP,AFP-L3和AFP-L3%的ROC曲线下面积大小分别是0.64,0.79和0.92;AFP-L3%诊断肝细胞癌灵敏度是82.3%,特异度是92.4%,YOUDEN指数为0.747,阳性预测值为85.5%,阴性预测值为92.5%。结论甲胎蛋白异质体(AFP-L3%)作为肝细胞癌的诊断指标明显优于AFP,值得临床推广应用。Objective To evaluate the diagnostic value of detecting α-Fetoprotein variants for discriminating hepato- cellular carcinoma and benign liver diseases. Methods α-Fetoprotein variants from 265 patients with liver diseases （hepatocellular carcinoma 79; benign liver diseases 186） were isolated with micro-spin column equipped lens eulinaris agglutinin （LCA）. The levels of AFP and AFP-L3 were then detected by ARCHITECT i2000 System,and the propor- tions of AFP-L3 （AFP-L3%） were calculated. Results AFP, AFP-L3 and AFP-L3% in patients with hepatocellular carcinoma was significantly higher than that in patients with benign liver diseases （P〈0.0l）. No significant relation- ship beween AFP-L3% and AFP （r=-0. 125,P〉0.05）;The area under curve （AUC） of AFP, AFP-L3 and AFP- L3% were respectively 0.64,0.79 and 0.92. The sensitivity of AFP-L3% in HCC diagnosis was 82.3% and the speci- ficity was 92.4% ;YOUDEN index of AFP-L3% was 0. 747, positive predictive value was 85.5%, negative predictive value was 92.5 %. Conclusion AFP-L3 （AFP-L3 %） is of clinical significance for discriminating hepatocellular carcino- ma and benign liver diseases.

关 键 词：甲胎蛋白异质体 肝细胞癌 微量离心柱法 

分 类 号：R735.7[医药卫生—肿瘤] R730.45[医药卫生—临床医学]