凝集素微量离心柱法检测甲胎蛋白异质体用于肝癌的诊断及分析

目的 应用凝集素微量离心柱法(ACSC)检测甲胎蛋白异质体(AFP-L3),分析AFP-L3在鉴别肝细胞癌(HCC)与良性肝脏病变中的价值.方法 选择132例临床检测AFP为阳性的肝病患者血清.应用装有耦联了小扁豆凝集素(LCA)的微量离心柱分离、洗脱获得AFP-L3,采用配套试剂在美国雅培AXSYM酶免疫分析仪检测AFP以及AFP-L3含量,计算AFP-L3在AFP中的比例即AFP-L3%.结果 以ACSC法分离AFP-L3操作简便;HCC患者血清AFP-L3%异常升高,其均值明显高于良性肝病患者(P<0.01);根据AFP-L3%计算受试者工作曲线(ROC)曲线下面积为0.807.以AFP-L3%≥10%为临界值,分析79例HCC患者与53例良性肝脏疾病患者,AFP-L3%异常的灵敏度为84.8%(67/79);特异性为92.5%(49/53),与临床总体符合率为87.9%.结论 应用ACSC辅助检测的AFP-L3在HCC与良性肝脏病变鉴别诊断中有一定临床价值.

Detection of α-fetoprotein-L3 using agglutinin-coupled spin column to be used in diagnosis of hepatocellular carcinoma

Objective To explore the effect of use of lens culinaris agglutinin(LCA)-coupled spin column(ACSC)in detection of α-fetoprotein(AFP)isoform AFP-L3 and to evaluate the value of AFP-L3 as a biomarker in diagnosis of hepatoeellular-carcinoma(HCC).Methods The serum samples of 132 patients with elevated AFP level(20-1000μg/L),79 diagnosed as with HCC and 53 with benign liver diseases(35 with liver cirrhosis and 18 with chronic hepatitis)underwent ACSC to isolate the fraction of AFP-L3.The contents of AFP and AFP-L3 were detected oy micro-particle immunoassay.The ratio of AFPL3 to toml AFP.AFP-L3%.was calculated.Correlation between the abnormMly elevated AFP-L3% and HCC was analyzed.Results Detection of AFP-L3%using ACSC method Was operating friendly.The average valUC of AFP-L3%in the patients with HCC was 36.4%.significantly higher than those of the patients with benign liver diseases(5.3%respectively,P<0.01).The area under the receiver operating characteristic(ROC)curve of AFP-L3%was 0.807.Taking AFP-L3%≥10%as diagnostic criteria,the sensitivity of AFP-L3%in HCC diagnosis Was 84.8%(67/79)and the specificity Was 92.5%(49/53),with a total conformity rate of 87.9%compared to the confirmed clinical diagnosis.Conclusion ACSC is of clinical value in detecting AFP-L3.AFP-L3% is a valuable biomarker in diagnosis and prediction of prognosis of HCC.