HS-AFP在肝癌早期诊断及鉴别诊断中的价值

目的：探讨肝癌特异性甲胎蛋白（HS—AFP）对肝细胞癌的诊断及鉴别诊断价值。方法：对105例肝癌患者及151例良性肝病血清HS—AFP及AFP进行检测，并对10例HS—AFP阳性的良性肝病患者进行15个月随访观察。HS—AFP采用不连续缓冲系统PAGE结合Westernblot分离检测，AFP采用化学发光法测定。结果：105例肝癌患者HS—AFP和AFP〉200μg／L阳性率分别为60．0％和50．5％（P〉0．05），良性肝病患者HS—AFP阳性率显著低于AFP〉200μg／L的阳性率（P〈0．05）。AFP处于50～400μg／L范围的肝癌组HS—AFP阳性率为77．1％，良性肝病组阳性率为13．6％（P〈0．01），151例良性肝病中有10例HS-AFP出现阳性，其中3例于随访期间检出肝癌。11例小体积肝癌HS—AFP阳性率（45．5％）高于AFP〉200μg／L的阳性率（18．2％）。结论：HS—AFP对肝癌的诊断价值优于AFP浓度。对肝癌高危人群监测HS—AFP有助于肝癌的早期诊断。对血清AFP中低浓度升高的良恶性肝病有较高的鉴别诊断价值、     

血清F对AFP阴性或低浓度原发性肝癌的诊断分析

为了探讨血清F对AFP不同浓度的原发性肝癌的诊断意义，自1993年1月至1994年12月，对243例原发性肝癌和46例健康对照组进行了血清AFP、F的检测。结果显示：原发性肝癌的血情AFP（＞400μg/L）、F（男＞250μg/L、女>150μg/L）的阳性率分别为47．7%,72．4%，与对照组比较二者差异均有高度显著性（P均＞0．01）。在AFP阴性、低浓度和阳性中F阳性率分别为73．2%（93／127）和71．6（83／116），二者比较差异无显著性（P＞0．05）。结果表明：F对原发性肝癌有诊断意义，尤其对AFP阴性、低浓度的原发性肝癌的诊断具有重要价值。     

AFP异质体测定在良恶性肝病鉴别诊断中的应用

[目的]探讨AFP异质体测定在良恶性肝病鉴别诊断中的价值.[方法]用亲和吸附法测定56例原发性肝癌(PHC)和67例慢性肝病患者的小扁豆凝集素亲和型甲胎蛋白(AFP-LCA-V)的百分含量,同时测定AFP的含量.[结果]以AFP-LCA-V＞25%为阳性判断标准,56例PHC患者中AFP-LCA-V阳性占85.75%,67例慢性肝病患者AFP-LCA-V阳性占49.3%.以20μg/L＜AFP＜400μg/L为低浓度阳性标准,则PHC组在其AFP低浓度阳性的病例中,AFP-LCA-V阳性检出率为83.3%,而慢性肝病组在其AFP低浓度阳性的病例中AFP-LCA-V阳性检出率为37.8%.[结论]亲和吸附法AFP异质体测定对良恶性肝病有很高的鉴别诊断价值,尤其对于低浓度阳性的AFP值,结合AFP-LCA-V测定,能有效地提高PHC的检出率.     

放射免疫分析法对原发性肝癌的早期诊断及价值

目的 探讨放射免疫法(RIA)在原发性肝癌早期诊断中的应用价值及可行性.方法 应用放射免疫法,检测239例肝病患者血清中甲胎蛋白异质体(AFP-L3)比值,以AFP-L3/AFP≥10％为阳性指标,并跟踪研究其病程发展,比较后期癌症确诊率.结果 放射免疫诊断法敏感度为99.12％,特异度为72.72％,阳性预测值为98.69％,阴性预测值为80.00％.与金标准相比在敏感度、特异度、阳性预测值等方面无显著性差异(P＞0.05),但两者的阴性预测值具有显著性统计学差异(P＜0.05).结论 本研究建立的原发性肝癌早期诊断方法特异性强、可信度高且操作方便,在原发性肝癌早期筛查应用中具有较高的可行性及应用价值.     

原发性肝癌中多项肿瘤标志物检测的临床意义

目的：探讨检测血清GGT、GGT-Ⅱ、AFP在诊断原发性肝癌中的临床意义.方法：选择原发性肝癌30例、肝硬化40 例、病毒性肝炎45例、肝损伤6例和正常对照者32例.血清GGT、GGT-Ⅱ、AFP分别采用化学免疫分析法、不连续缓冲系统聚丙烯酰胺凝胶垂直电泳检测法和自动生化仪进行检测.结果：原发性肝癌组GGT 为（281±198）U/L,AFP 为（3167±867） μg/L,明显高于肝硬化组[GGT：（203±135）U/L,P＜0.05;AFP：（403±274）μg/L,P＜0.01]、病毒性肝炎组[ GGT：（173±125）U/L,P＜0.05;AFP：（102±95）μg/L,P＜0.01]、肝损伤组[GGT：（401±212）U/L,AFP：（16±14）μg/L,P＜0.01]及正常对照者组[GGT：（26.0±5.1）U/L,P＜0.05;AFP：（2.1±1.0）μg/L,P＜0.01];诊断原发性肝癌的特异性AFP最高为（91%）,灵敏度最高为GGT-Ⅱ（93%）;若将三者联合检测,诊断原发性肝癌的灵敏度可达96%.结论：肿瘤标志物的联合检测可提高原发性肝癌的诊断率.     

血清铁蛋白、甲胎蛋白和甲胎蛋白异质体联合检测对原发性肝癌诊断的临床意义

目的 探讨血清铁蛋白（Fer）、甲胎蛋白（AFP）、甲胎蛋白异质体（AFP-L3）联合检测对原发性肝癌的诊断价值.方法 健康对照组84名、原发性肝癌组92例、良性肝病组45例均同时检测血清Fer、AFP、AFP-L3.结果 原发性肝癌组血清Fer检测结果为（819.4±616.8）μg/L,AFP为（556.9±451.5）μg/L,AFP-L3为（109.0±62.5） μg/L,良性肝病组Fer检测结果为（229.3±155.5） μg/L,AFP为（6.0±4.2） μg/L,AFP-L3为（26.0±49.4） μg/L,健康对照组Fer检测结果为（125.6±110.5）μg/L,AFP为（2.8±0.8） μg/L,AFP-L3为（7.0± 1.8）μg/L,三者差异有统计学意义（均P＜0.01）.原发性肝癌组单独检测血清Fer的敏感度为85.9％,AFP的敏感度为71.0％,AFP-L3的敏感度为83.7％,联合检测Fer和AFP或AFP-L3可使检测敏感度提高到90.2％和95.7％,三者联合检测敏感度为98.9％.结论 联合检测血清Fer、AFP、AFP-L3三项指标可以提高原发性肝癌的诊断准确率.     

甲胎蛋白异质体的亲和吸附法测定

对41例肝癌，58例慢性肝病患者采用固相比的扁豆凝集素（LCA）和刀豆凝集素A（ConA）吸附血清中相应的AFP异质体，然后用化学发光免疫测定未被凝集素结合的AFP，并与未吸附样品的总AFP值比较，能在50分钟内得出结果，灵敏度为0．9μg/L，CV可达8．3％，与亲和电泳免疫印迹法比较结果高度相关（r=0．895)；亲和吸附法测珲AFP异质体是一种适合临床诊断的方法。     

甲胎蛋白异质体对肝癌诊断的临床意义

[目的]分析甲胎蛋白异质体（AFP-L3）在诊断肝癌上的临床应用价值。[方法]采用亲和离心管方法检测160例甲胎蛋白（AFP）阳性（≥20μg/L）患者血清中AFP-L3含量,计算其比率AFP-L3（%）,即AFP-L3/AFP。[结果]以AFP-L3（%）≥10%作为阳性标准,肝癌患者血清中AFP-L3（%）异常升高者比例明显高于其他肝病患者（75.00%vs.8.33%,χ2=71.11,P〈0.01）。AFP-L3的诊断灵敏度是75.00%（66/88）,特异度达到91.67%（66/72）,诊断符合率82.50%[（66＋66）/160]。[结论]应用亲和离心管法检测AFP-L3在肝癌与良性肝脏病变鉴别诊断中具有重要临床价值。     

α-1，6岩藻糖基转移酶与甲胎蛋白异质体在原发性肝癌诊断中的应用

目的：分析α-1,6岩藻糖基转移酶（FUT8）与甲胎蛋白异质体（AFP - L3）在原发性肝癌（PLC）诊断中的应用价值。方法：采用酶联免疫吸附试验（ELISA）方法分别检测我院92例 PLC 患者和42例非原发肝癌（NPLC）患者血清中 FUT8和 AFP - L3。结果：经统计学分析,PLC 组与 NPLC 组血清 FUT8和 AFP - L3比较差异有统计学意义（P ﹤0.05）。结论：α-1,6岩藻糖基转移酶（FUT8）与甲胎蛋白异质体（AFP - L3）在原发性肝癌（PLC）诊断中有一定的应用价值。     

岩藻糖苷酶和甲胎蛋白联合检测对肝癌患者术后复发的预测价值

 目的　探讨联合检测血清中α-L岩藻糖苷酶（AFU）和甲胎蛋白（AFP）在预测肝癌术后复发的价值。方法　按术后复发组、术后未复发组和健康对照组分3组检测血清AFU、AFP水平,AFU 检测采用比色速率法,设定AFU＞40 U／L为阳性;AFP检测采用化学发光免疫法,设定 AFP＞13.6 μg／L为阳性。结果　术后复发组与术后未复发组、健康对照组比较,AFU、AFP水平差异有统计学意义（P＜0.001）;AFU、AFP水平在术后未复发组较健康对照组高,但差异无统计学意义（P＞0.05）。术后复发组肝癌复发前后AFU、AFP差异有统计学意义（P＜0.001）。AFU+AFP联合检测与AFU、AFP单独检测相比敏感度、准确度差异有统计学意义（P＜0.001）,但AFU与AFP相比差异无统计学意义（P＞0.05）;AFU+AFP、AFU、AFP三者特异度比较,差异无统计学意义（P＞0.05）。结论　联合检测血清中AFU、AFP水平,可显著提高肝癌术后复发的诊断率,并可作为预测肝癌术后复发的检测指标。     

腹部超声、CT联合血清甲胎蛋白诊断原发性肝癌的临床价值

目的:研究腹部超声、CT联合血清甲胎蛋白（AFP）诊断原发性肝癌的价值。方法:回顾性分析我院于2017年1月至2018年1月期间收治的50例确诊原发性肝癌患者作为肝癌组,另选取同期收治的50例肝脏良性肿瘤患者作为良性组及50例来院参加健康体检的志愿者作为对照组。以病理结果为标准,对比三组受检者的腹部超声、CT诊断阳性率,血清AFP水平,联合诊断的敏感度、特异度、阳性预测值及阴性预测值,并研究联合诊断不同分期原发性肝癌的阳性率。结果:三组受检者对比,肝癌组患者的腹部超声、CT诊断阳性率及AFP水平均高于良性组及对照组,且良性组高于对照组,差异均有统计学意义(P＜0.05)。腹部超声、CT及AFP联合诊断Ⅰ-Ⅱ期及Ⅲ-Ⅳ期肝癌的阳性率高于单项诊断,差异均有统计学意义(P＜0.05)。诊断效能对比,腹部超声、CT及AFP联合诊断的特异度、敏感度、阴性预测值及阳性预测值均高于单项诊断,差异均有统计学意义(P＜0.05)。结论:腹部超声、CT联合血清AFP诊断原发性肝癌,较各单项诊断阳性率高,且联合诊断的敏感性及特异性更好,可有效明确肝癌分期,值得在临床上推广。     

DETECTION OF ALPHA-1 ANTICHYMOTRYPSIN IN HEPATOCELLULAR CARCINOMA TISSUE

One hundred and fifty-three consecutive cases of HCC and 25 controls from autopsy material were studied by immunohistochemical method in this paper. A review of the histopathology and demonstration of AFP, alpha- 1-antichymotrypsin (AACT), alpha 1-antitrypsin (AAT) and CEA were made.Among the tumor markers. AACT yielded the highest positive rate, 109 cases (71%) out of 153 HCC. CEA was the next, 95 cases (62%) .AFP and AAT gave the same result, 72 cases (47%) . AACT, AAT and CEA were not found in the controls. AFP was present in a few hepatocytes in 1 of 25 controls. The results were in keeping with serum tests so far as the highest positive rate being AACT was concerned. Therefore, combined determination of AACT and AFP would seem a better screening method than by that of AFP alone for survey of HCC.     

血清YKL-40联合AFP与AST对肝细胞癌的诊断价值

目的:探讨血清YKL-40对肝细胞癌的诊断价值。方法:选取157例原发性肝细胞癌患者,51例肝良性疾病患者以及72例健康人纳入试验。ELISA法检测血清YKL-40浓度;应用ROC曲线分析,计算其敏感性、特异性和cutoff值,并与其他血清标志物比较曲线下面积,探讨其诊断价值。结果:血清YKL-40诊断肝细胞癌的cutoff值为69.35 ng/ml,肝癌组YKL-40浓度显著高于肝良性疾病组和健康人群组（P<0.001）。YKL-40在区分肝癌与健康人群、肝癌与肝良性疾病的敏感性和特异性分别为86.0%和93.1%,91.1%和43.1%。AST在早期肝癌和AFP阴性肝癌的AUC分别为0.846和0.862;YKL-40,AFP和AST联合用于区分肝癌与肝良性疾病的AUC为0.909。结论:血清YKL-40是一个潜在的独立的诊断肝细胞癌的标志物,YKL-40联合AFP与AST对于早期肝癌和AFP阴性肝癌有较好的诊断价值。     

The reactivity of alpha-1-antitrypsin with Lens culinaris agglutinin and its usefulness in the diagnosis of neoplastic diseases of the liver

The reactivity of alpha-1-antitrypsin (AAT) with Lens culinaris agglutinin (LCA) was studied by crossed immuno-affinity electrophoresis of the sera of 246 subjects from 6 groups (acute virus hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma (HCC), carcinoma metastatic to the liver and normal controls). Two species of AAT (LCA-reactive and -nonreactive species) were detected on crossed immuno-affinity electrophoresis in a gel containing LCA. The percentages of LCA-reactive species of AAT in neoplastic diseases of the liver were significantly higher than those in benign liver diseases and normal controls. There was no correlation between the percentage of LCA-reactive species of AAT and serum AAT concentration in any group. Furthermore, in studying 15 pairs of serum samples before and after the subsequent development of HCC, the percentage of LCA-reactive species of AAT after HCC occurrence was significantly higher than that before, although there was no statistically significant difference between the serum AAT concentration before and after development of the disease. The latter 15 patients were all of the normal protease inhibitor phenotype (PiMM) and no change in phenotype was observed before and after the development of HCC. The results indicate that measurement of the reactivity of AAT with LCA can be a useful marker for the diagnosis of HCC and carcinoma metastatic to the liver, especially when serum concentrations of alpha-foetoprotein or other tumour markers are within the normal ranges.     

成人隐睾内胚窦瘤3例报道及文献复习

目的 报道3例成人隐睾内胚窦瘤并进行文献复习。方法 对此病的临床病理学特征进行详细分析，结果 内胚窦瘤病人的血清AFP高于正常，组织结构以疏松网状结构、嗜酸性透明小体、腺泡状和腺管状结构、S—D小体最为常见，免疫绀化AFP、CK、Vimentin均为阳性，AAT两例阳性，CEA、hCG三例均阴性。结论 检测血清中AFP对内胚窦瘤的早期诊断、监测肿瘤是否复发转移有重要价值，确诊主要依靠病理诊断。     

Serum Talin-1 is a Potential Novel Biomarker for Diagnosis of Hepatocellular Carcinoma in Egyptian Patients

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer mortality worldwide. The outcome ofHCC depends mainly on its early diagnosis. To date, the performance of traditional biomarkers is unsatisfactory.Talins were firstly identified as cytoplasmic protein partners of integrins but Talin-1 appears to play a crucial rolein cancer formation and progression. Our study was conducted to assess the diagnostic value of serum Talin-1(TLN1) compared to the most feasible traditional biomarker alpha-fetoprotein (AFP) for the diagnosis of HCC.Methods: TLN1 was detected using enzyme linked immunosorbent assay (ELISA) in serum samples from 120Egyptian subjects including 40 with HCC, 40 with liver cirrhosis (LC) and 40 healthy controls (HC). Results:ROC curve analysis was used to create a predictive model for TLN1 relative to AFP in HCC diagnosis. Serumlevels of TLN1 in hepatocellular carcinoma patients were significantly higher compared to the other groups(p<0.0001). The diagnostic accuracy of TLN1 was higher than that of AFP regarding sensitivity, specificity,positive predictive value and negative predictive value in diagnosis of HCC. Conclusions: The present studyshowed for the first time that Talin-1 (TLN1) is a potential diagnostic marker for HCC, with a higher sensitivityand specificity compared to the traditional biomarker AFP.     

Alpha-1 antitrypsin (AAT) and alphafoetoprotein (AFP) in sera of patients with germ-cell neoplasms: value as tumour markers in patients with endodermal sinus tumour (yolk sac tumour).

Serum alphafoetoprotein (AFP) and serum alpha-1 antitrypsin (AAT) were determined in 24 patients with germ-cell neoplasms of the gonads and extragonadal sites and in two patients with hepatocellular carcinoma. In the majority of the patients serial determinations were performed. All seven patients with testicular seminoma and four patients without evidence of active disease had normal levels of serum AAT and AFP. The remaining 13 patients with germ-cell neoplasms had tumours containing endodermal sinus tumour (yolk-sac tumour) elemetns. All these 13 patients had elevated levels of serum AFP and the levels were high or very high in most cases. Nine of these 13 patients had raised serum AAT, although the elevation above normal levels was only slight in a number of cases. When serial determinations were performed serum AAT levels frequently followed the pattern of serum AFP levels, but the AAT levels were frequently within normal limits and therefore the interpretation of the results was difficult, and much less reliable as compared with those for serum AFP. The elevation of serum AAT levels following the recurrence of the tumour was found to occur much later and was much less marked than elevation of serum AFP, which occurred early, showed a large rise and was a reliable marker of tumour recurrence in patients with germ-cell neoplasms containing endodermal sinus tumour elements. It is therefore considered that, although there is good evidence that serum AAT is produced by endodermal sinus tumour elements, serum AAT is not a useful monitor of disease activity in these patients, especially when compared with serum AFP, the value of which is well recognized. Serum AAT may be a useful tumour marker in patients with hepatocellular carcinoma, and this aspect should be investigated further.     

肝癌冷冻治疗前后血清AFP变化的临床观察

目的：探讨肝癌冷冻治疗前后血清中AFP的动脉变化,从而判断治疗效果。方法：分析肝癌患者46例冷冻治疗前后血清AFP的动态变化。结果：术前AFP阴性肝癌患者,术后3天AFP值升高迅速,术后半月持续阳性,不易转阴;术前AFP阳性肝癌患者,术后3天不明显,术后半月AFP值降至基本正常。结论：AFP值的变化在肝癌冷冻治疗中有一定特征,检测AFP值变化可以对肝癌冷冻治疗的疗效和预后作出判断。     

Clinical Value of Hepatoma-Specific Alpha-Fetoprotein in the Diagnosis of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a common malignant tumor worldwide and the number 2 cause of cancer mortality in Chi- na.[1] It often develops in cases of liver cirrhosis and chronic hepati- tis. [1-3] Advanced imaging procedures including utrasonograph…     

84例原发性肝癌患者肝动脉化疗栓塞术后预后的影响因素分析

目的 探讨原发性肝癌患者肝动脉化疗栓塞(TACE)术后预后影响因素及预后诊断指标的价值.方法 选取行TACE治疗的84例原发性肝癌患者,采用Cox风险比例模型分析患者的预后因素,另选取80例肝囊肿患者为对照组,采用酶联免疫吸附法测定两组患者的血清AFP、SCC、CYFRA21-1水平.结果 经Cox风险比例模型分析可知,门脉癌栓、肝内转移、Child-Pugh分级、AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者远期预后的独立危险因素.原发性肝癌组患者TACE术前、术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率均高于对照组,而TACE术后血清AFP、SCC、CYFRA21-1水平及AFP、SCC、CYFRA21-1阳性率低于TACE术前,差异均有统计学意义(P<0.05).结论 AFP术后阳性、SCC术后阳性、CYFRA21-1术后阳性是原发性肝癌患者TACE术后预后的独立危险因素,在预测原发性肝癌患者TACE术后预后方面具有潜在的临床价值.