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目的:探讨甲胎蛋白异质体在肝脏良恶性疾病诊断中的意义。方法:采用微量离心柱法对240例肝病患者(原发性肝癌70例,肝癌术后10例,肝硬化63例,慢性肝炎97例),采用化学发光法检测AFP及AFP-L3水平,计算AFP-L3和AFP比例。结果:原发性肝癌组患者血清中的AFP,AFP-L3%阳性率显著高于肝癌术后组,肝硬化组和慢性肝炎组。AFP-L3%的灵敏度为86.96%,特异性为88.30%,Youden指数为0.75。AFP的灵敏度为75.68%,特异性为85.54%,Youden指数为0.61。从Youden指数可以知道AFP-L3%是比AFP更好的诊断肝癌的指标。原发性肝癌组患者血清中的AFP、AFP-L3%含量显著高于肝癌术后组、肝硬化组和慢性肝炎组(F值分别为74.45、54.85,P值均<0.01)。诊断为原发性肝癌病人中,当AFP>400 ng/ml时,AFP-L3%的阳性率为95.23%。AFP-L3%与AFP水平无相关性。结论:AFP-L3%对于肝癌的诊断有较高的灵敏性和特异性;是比AFP更好的诊断指标;可以作为诊断肝癌的独立指标。
Objective: To investigate the significance of alpha-fetoprotein heterogeneity in the diagnosis of benign and malignant liver diseases. Methods: The levels of AFP and AFP-L3 in 240 patients with liver disease (70 cases of primary liver cancer, 10 cases of liver cancer after surgery, 63 cases of liver cirrhosis and 97 cases of chronic hepatitis) were detected by micro-centrifugation column method. AFP-L3 and AFP ratio. Results: The positive rates of AFP and AFP-L3% in serum of patients with primary liver cancer were significantly higher than those of patients with liver cancer, cirrhosis and chronic hepatitis. AFP-L3% had a sensitivity of 86.96%, a specificity of 88.30%, and a Youden index of 0.75. AFP sensitivity of 75.68%, specificity of 85.54%, Youden index of 0.61. The Youden index shows that AFP-L3% is a better indicator of liver cancer than AFP. The serum levels of AFP and AFP-L3% in patients with primary liver cancer were significantly higher than those in patients with postoperative liver cancer, cirrhosis and chronic hepatitis (F = 74.45 and 54.85, respectively, P <0.01). Among patients diagnosed with primary liver cancer, the AFP-L3% positive rate was 95.23% at AFP> 400 ng / ml. No correlation was found between AFP-L3% and AFP levels. Conclusion: AFP-L3% is highly sensitive and specific for the diagnosis of liver cancer. It is a better diagnostic indicator than AFP and can be used as an independent indicator in the diagnosis of liver cancer.