血清甲胎蛋白、甲胎蛋白异质体、磷脂酰肌醇蛋白聚糖-3联合诊断肝细胞肝癌的临床价值  

Clinical value of combination of serum alpha-fetoprotein,alpha-fetoprotein heterosomes and phosphatidylinositol proteoglycan 3 in the diagnosis of hepatocellular carcinoma

作　　者：李辉[1] 赵娟[2] 徐沛演 张成芳[4] 谭丽娟[3] 刘美三[3] LI Hui;ZHAO Juan;XU Peiyan;ZHANG Chengfang;TAN Lijuan;LIU Meisan(Department of Internal Medicine,the People′s Hospital of Huadu District,Guangzhou City,Guangdong Province,Guangzhou510800,China;Department of Laboratory,the People′s Hospital of Huadu District,Guangzhou City,Guangdong Province,Guangzhou510800,China;Department of Infectious Diseases,the People′s Hospital of Huadu District,Guangzhou City,Guangdong Province,Guangzhou510800,China;Department of Oncology,the People′s Hospital of Huadu District,Guangzhou City,Guangdong Province,Guangzhou510800,China)

机构地区：[1]广州市花都区人民医院内科,广东广州510800 [2]广州市花都区人民医院检验科,广东广州510800 [3]广州市花都区人民医院感染性疾病科,广东广州510800 [4]广州市花都区人民医院肿瘤科,广东广州510800

出　　处：《中国当代医药》2022年第9期66-69,共4页China Modern Medicine

基　　金：广东省广州市科技计划项目(202002030044);广东省广州市花都区人民医院院内科研基金项目(2020B03)。

摘　　要：目的研究血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、磷脂酰肌醇蛋白聚糖-3(GPC3)联合诊断肝细胞肝癌(HCC)的临床价值。方法选取2018年4月至2021年3月广州市花都区人民医院诊断的136例疑似HCC患者纳入HCC组,129例肝脏良性疾病患者纳入良性组,选取同期广州市花都区人民医院诊治的140例肝炎肝硬化患者纳入对照组。检测并比较三组患者的血清AFP、AFP-L3、GPC3水平,以术后肝组织病理活检为金标准,评价AFP、AFP-L3、GPC3单独、联合诊断HCC的价值。结果HCC组患者的血清AFP、AFP-L3、GPC3水平均高于良性组、对照组,良性组患者的血清AFP、AFP-L3、GPC3水平均高于对照组,差异有统计学意义(P<0.05)。AFP、AFP-L3、GPC3联合诊断HCC的灵敏度、特异度、阴性预测值、阳性预测值、准确度均高于AFP、AFP-L3、GPC3单独及两两联合诊断。结论血清AFP、AFP-L3、GPC3与HCC关系密切,检测其水平有助于HCC的临床诊断,三者联合检测可显著提高HCC诊断率。Objective To study the clinical value of serum alpha-fetoprotein(AFP),alpha-fetoprotein-L3(AFP-L3)and glypican-3(GPC3)in the combined diagnosis of hepatocellular carcinoma(HCC).Methods A total of 136 Patients with suspected HCC diagnosis in the People′s Hospital of Huadu District,Guangzhou City from April 2018 to March 2021 were selected as the HCC group,129 patients with benign liver diseases were selected as the benign group,and 140 patients with hepatitis and cirrhosis treated in the People′s Hospital of Huadu District,Guangzhou City during the same period were selected as the control group.The serum levels of AFP,AFP-L3,and GPC3 in the three groups were detected and compared.Postoperative liver biopsy was used as the gold standard to evaluate the value of AFP,AFP-L3,and GPC3 for the diagnosis of HCC alone or in combination.Results The levels of AFP,AFP-L3,and GPC3 in the HCC group were higher than those in the benign group and the control group,and the levels of AFP,AFP-L3 and GPC3 in the benign group were higher than those in the control group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,negative predictive value,positive predictive value and accuracy of AFP,AFP-L3,and GPC3 combined diagnosis for HCC were higher than AFP,AFP-L3,and GPC3 alone or in combination.Conclusion Serum AFP,AFP-L3,and GPC3 are closely related to HCC.Detection of their levels is helpful for the clinical diagnosis of HCC,and combined detection of the three can significantly improve the diagnosis rate of HCC.

关 键 词：甲胎蛋白 甲胎蛋白异质体 铁蛋白 肝细胞肝癌 

分 类 号：R735.7[医药卫生—肿瘤]