甲胎蛋白异质体测定在原发性肝癌和良性肝病鉴别诊断中的应用分析  

Application analysis of alpha-fetoprotein heterogeneity in differential diagnosis of primary liver cancer and benign liver disease

作　　者：李晓峰[1] 王其[1] 童涌[1] LI Xiaofeng;WANG Qi;TONG Yong(Department of Infectious Diseases, Huzhou Central Hospital, Huzhou 313000, China)

机构地区：[1]浙江省湖州市中心医院感染科,浙江湖州313000

出　　处：《中国现代医生》2018年第4期5-7,11,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2012C13018-2)

摘　　要：目的分析甲胎蛋白(α-fetoprotein,AFP)异质体测定在原发性肝癌和良性肝病鉴别诊断中的应用价值。方法选择2016年3月~2017年4月本院收治的慢性乙型肝炎病毒患者104例作为研究对象,其中包括原发性肝癌53例,各类良性肝病患者51例;所有患者均进行微量离心柱法分离小扁豆凝集素结合型AFP-L3(甲胎蛋白异质体、AFP-L3、AFP-L3 variant)测定,并通过实施化学发光法测定甲胎蛋白含量、AFP-L3水平及AFP-L3占总甲胎蛋白的比率。检测后所有检测结果均以AFP-L3>10%为阳性作为诊断标准、AFP≥400 ng/m L为阳性作为判断标准。结果 53例原发性肝癌患者中,AFP-L3>10%43例(81.1%);51例各类慢性肝病患者中,AFP-L3>10%5例(9.8%),肝癌AFP-L3阳性率明显高于良性肝病阳性率(P<0.05)。53例原发性肝癌患者中,AFP>400 ng/m L33例(62.3%);51例各类慢性肝病患者中,AFP≥400 ng/m L 14例(27.5%),肝癌AFP阳性率明显高于良性肝病阳性率(P<0.05)。肝癌患者AFP-L3>10%、AFP≥400 ng/m L比较差异不明显(P>0.05)。结论在原发性肝癌和良性肝病鉴别诊断中,通过甲胎蛋白异质体测定,能有效区分肝癌与良性肝病,弥补AFP诊断中的不足之处,具有一定的临床诊断实用性,值得临床推广应用。Objective To analyze the application value of AFP(α-fetoprotein)heterogeneity in the differential diagnosis of primary liver cancer and benign liver disease.Methods A total of104patients with chronic hepatitis B virus admitted in our hospital from March2016to April2017were selected,including53patients with primary liver cancer and51patients with various types of benign liver disease.All patients underwent microcentrifuge column method to Isolate lentil lectin-binding AFP-L3(alpha-fetoprotein heterogeneity,AFP-L3,AFP-L3variant).The alpha-fetoprotein content,the AFP-L3level and the ratio of AFP-L3to total alpha-fetoprotein were determined by chemiluminescence assay.After detection,the AFP-L3>10%was as a positive diagnostic criteria and the AFP≥400ng/mL was as a positive standard.Results Of the53patients with primary liver cancer,there were43patients with AFP-L3>10%(81.1%).In51patients with chronic liver disease,there were5patients with AFP-L3>10%(9.8%).The positive rate of AFP-L3in hepatocellular carcinoma was significantly higher than that in benign liver disease(P<0.05).There were33patients with AFP>400ng/mL(62.3%)in53patients with primary liver cancer.There were14patients with AFP≥400ng/mL(27.5%)in51cases of chronic liver disease.AFP positive rate of liver cancer was significantly higher than that of benign liver disease(P<0.05).There were no significant differences in AFP-L3>10%and AFP≥400ng/mL between the two groups(P>0.05).Conclusion In the differential diagnosis of primary hepatocellular carcinoma and benign liver disease,the determination of alpha-fetoprotein heterogeneity can effectively distinguish between liver cancer and benign liver disease and make up for the deficiency of AFP diagnosis,which has some clinical diagnosis practicality and is worthy of promotion and application.

关 键 词：甲胎蛋白异质体测定 原发性肝癌 良性肝病 鉴别诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]