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目的:探讨甲胎蛋白异质体在良恶性肝病鉴别诊断及肝癌预警中的临床意义。方法:200例肝病患者血清,其中肝癌98例,肝硬化46例、慢性肝炎56例,分别检测AFP以及AFP-L3含量,计算AFP-L3占总AFP的比率,对AFP-L3异常升高非肝癌患者进行跟踪。结果:肝癌患者血清中AFP-L3数值及阳性率明显高于肝硬化、慢性肝炎组(P<0.01);AFP-L3诊断肝细胞癌灵敏度(72.3%),但特异性较高(97.0%),AFP-L3的百分比与AFP浓度不相关(r=0.16,P>0.05)。AFP-L3阳性的3例非肝癌患者,12个月内有3例发生肝癌。结论:检测甲胎蛋白异质体(AFP-L3)在良恶性肝病的鉴别诊断及肝癌预警中具有重要意义。
Objective: To investigate the clinical significance of alpha-fetoprotein heterogeneity in differential diagnosis of benign and malignant liver diseases and early warning of liver cancer. Methods: The serum levels of AFP-L3, AFP-L3 and total AFP in 200 cases of liver disease were detected in 98 cases of hepatocellular carcinoma, 46 cases of liver cirrhosis and 56 cases of chronic hepatitis. The levels of AFP-L3 and AFP- Liver cancer patients to track. Results: The serum AFP-L3 value and positive rate in patients with hepatocellular carcinoma were significantly higher than those in patients with cirrhosis and chronic hepatitis (P <0.01). The sensitivity of AFP-L3 in hepatocellular carcinoma was 72.3%, but the specificity was 97.0% , The percentage of AFP-L3 was not correlated with AFP concentration (r = 0.16, P> 0.05). Three of the AFP-L3 positive non-HCC patients developed HCC in 12 months. Conclusion: It is of great significance to detect AFP-L3 in the differential diagnosis of benign and malignant liver diseases and early warning of liver cancer.