AFP、DCP和AFP-L3%联合检测对肝细胞肝癌的诊断价值  

Combined detection of serum AFP, DCP and AFP-L3% in the diagnosis of hepatocellular carcinoma

作　　者：张明跃[1] 陈浩[1] ZHANG Mingyue;CHEN Hao(Clinical Gene Amplification Laboratory,Baoding Infectious Disease Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市传染病医院临床基因扩增检验实验室,河北保定071000

出　　处：《癌症进展》2019年第6期719-721,共3页Oncology Progress

摘　　要：目的分析甲胎蛋白(AFP)、AFP-L3异质体比率(AFP-L3%)、异常凝血酶原(DCP)单独及联合检测对肝细胞肝癌(HCC)的诊断价值。方法选择86例慢性肝炎患者(慢性肝炎组)、133例原发性胆汁性肝硬化患者(肝硬化组)和145例HCC患者(HCC组)并采集血清,采用全自动化学发光免疫分析仪检测血清AFP、AFP-L3和DCP水平,仪器自动计算AFP-L3占AFP的比率,即AFP-L3%。根据血清AFP水平,将HCC患者分为阴性组(0≤AFP﹤7 ng/ml)、阳性低浓度组(7 ng/ml≤AFP﹤400 ng/ml)和阳性高浓度组(AFP≥400 ng/ml),比较不同组别患者的AFP-L3%和DCP阳性率。结果 HCC组患者的AFP、DCP水平及AFP-L3%均高于慢性肝炎组和肝硬化组患者,肝硬化组患者的DCP水平和AFP-L3%均高于慢性肝炎组患者,差异均有统计学意义(P﹤0.05)。与AFP、DCP及AFP-L3%单独诊断比较,AFP、DCP及AFP-L3%联合诊断HCC的灵敏度、阴性预测值和约登指数较高。阳性低浓度组和阳性高浓度组患者的AFP-L3%和DCP阳性率均高于阴性组,差异均有统计学意义(P﹤0.05)。结论 AFP、DCP及AFP-L3%联合检测对HCC具有较高的诊断价值。Objective To explore the diagnostic value of α-fetoprotein (AFP), ratio of AFP-L3 isoform (AFP-L3%), des- gamma- carboxy prothrombin (DCP) alone or in combination for diagnosis of hepatocellular carcinoma (HCC). Method The serum specimens were collected from 86 cases of chronic hepatitis (chronic hepatitis group), 133 cases of primary biliary cirrhosis (cirrhosis group) and 145 cases of HCC, and then the level of serum AFP, AFP-L3 and DCP were detected with chemiluminescent immunoassay, AFP-L3% was calculated automatically. By serum AFP level, HCC patients were stratified as negative AFP group (0≤AFP<7 ng/ml), positive low AFP group (7 ng/ml≤AFP<400 ng/ml), and positive high AFP group (AFP≥400 ng/ml), the positive rates of AFP-L3% and DCP in each group were compared. Result The level of AFP, DCP and AFP-L3% in HCC group were significantly higher than that in cirrhosis and chronic hepatitis group, the level of DCP and AFP-L3% in cirrhosis group were significantly higher than that in chronic hepatitis group, and the differences were of statistical significance (P<0.05). The sensitivity, negative predictive value and Youden index of AFP, DCP, and AFP-L3% applied alone did not compare with those of combined detection of AFP+DCP+AFPL3%. Higher positive rate of AFP-L3% and DCP were observed in positive high and low AFP groups compared with negative AFP group, demonstrating statistically significant differences (P<0.05). Conclusion Combined detection of AFP+ DCP+AFP-L3% is clinically favorable for the diagnosis of HCC.

关 键 词：肝细胞肝癌 甲胎蛋白 异常凝血酶原 甲胎蛋白异质体比率 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]