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目的:研究原发性肝癌患者血清α-L-岩藻糖苷酶（AFU）和甲胎蛋白异质体3（AFP-L3）水平变化及临床意义，为临床研究提供指导。方法:选取杭州市大江东医院2018年1月至2019年10月收治的原发性肝癌患者65例为原发性肝癌组，良性肝病患者59例为良性肝病组，健康体检者70例为对照组进行研究。观察三组受检者AFP-L3、AFU水平，比较其单项、联合检测的阳性率及其与病理参数的关系。结果:原发性肝癌组血清AFP-L3、AFU水平分别为（30.15±2.92）%、（71.62±3.02）U/L，均明显高于良性肝病组的（6.28±0.82）%、（15.07±2.14）U/L和对照组的（2.78±0.61）%、（8.55±1.27）U/L，差异均有统计学意义（n F1=174.744，n F2=45.492，均n P<0.05）；良性肝病组均明显高于对照组，差异均有统计学意义（n F1=27.751，n F2=21.415，均n P<0.05）。原发性肝癌组联合检测阳性率为93.85%，AFP-L3检测阳性率为76.92%，AFU检测阳性率为84.62%，联合检测阳性率显著高于单项检测阳性率（χn 2=7.372，n P<0.05）；原发性肝癌组AFP-L3检测、AFU检测以及联合检测阳性率均明显高于良性肝病组和对照组，差异均有统计学意义（χn 21=98.959，χn 22=110.483，χn 23=139.423，均n P<0.05）；良性肝病组AFP-L3检测、AFU检测以及联合检测阳性率均高于对照组，差异均有统计学意义（χn 21=14.268，χn 22=18.632，χn 23=12.252，均n P0.05）；与淋巴结是否转移、TNM分期以及是否有癌栓差异均有统计学意义（n t1=33.265，n t1=27.936，n t1=31.834；n t2=22.467，n t2=21.599，n t2=28.478，均n P<0.05）。n 结论:原发性肝癌患者血清AFP-L3、AFU水平显著升高，两者联合检测可提高诊断的阳性率，对指导后续治疗具有重要意义。“,”Objective:To investigate the changes and clinical significance of serum alpha-L-fucosidase (AFU) and alpha-fetoprotein-L3 (AFP-L3) levels in patients with primary liver cancer, providing guidance for clinical studies.Methods:Sixty-five patients with primary liver cancer who received treatment from January 2018 to October 2019 in Dajiangdong Hospital were included in the primary liver cancer group. Fifty-nine patients with benign liver disease who concurrently received treatment were included in the benign liver disease group. Additional 70 healthy controls who concurrently underwent health examination were included in the control group. Serum levels of AFU and AFP-L3 were detected in three groups. AFU-positive rate, AFP-L3-positive rate and AFU-/AFP-L3-positive rate were compared among three groups to investigate their relationship with pathological parameters.Results:Serum levels of AFP-L3 and AFU were (30.15 ± 2.92)% and (71.62 ± 3.02) U/L respectively in the primary liver cancer group, which were significantly higher than (6.28 ± 0.82)% and (15.07 ± 2.14) U/L in the benign liver disease group and (2.78 ± 0.61)% and (8.55 ± 1.27) U/L in the control group (n F1 = 174.744, n F2 = 45.492, both n P < 0.05). Serum levels of AFP-L3 and AFU in the primary liver cancer group were significantly higher than those in the control group ( n F1 = 27.751, n F2 = 21.415, both n P < 0.05). In the primary cancer liver group, AFU-/AFP-L3-positive rate was 93.85%, AFP-L3-positive rate was 76.92%, and AFU-positive rate was 84.62%. In the primary cancer liver group, AFU-/AFP-L3-positive rate was significantly higher than AFP-L3-positive rate or AFU-positive rate (χ n 2 = 7.372, n P < 0.05). AFP-L3-positive rate, AFU-positive rate and AFU-/AFP-L3-positive rate in the primary liver cancer group were significantly higher compared with the benign liver disease and control groups (χ n 21 = 98.959, χn 22 = 110.483, χn 23 = 139.423, all n P < 0.05). AFP-L3-positive rate, AFU-positive rate and AFU-/AFP-L3-positive rate in the benign liver disease group were significantly higher than those in the control group (χ n 21 = 14.268, χn 22 = 18.632, χn 23 = 12.252, all n P 0.05). There were significant differences in serum levels of AFP-L3 and AFU between primary liver cancer patients with lymph node metastasis and those without lymph node metastasis, between primary liver cancer patients with different tumor-node-metastasis stages, and between primary liver cancer patients with tumor thrombus and those without tumor thrombus ( n t1 = 33.265, n t1 = 27.936, n t1 = 31.834; n t2 = 22.467,n t2 = 21.599, n t2 = 28.478, all n P < 0.05).n Conclusion:In patients with primary liver cancer, serum levels of AFP-L3 and AFU increase. The combined detection of AFP-L3 and AFU can increase the positive diagnosis rate of primary liver cancer, which is of great significance to guide the follow-up treatment.