AFP、AFU、Y-GT在肝癌诊断及鉴别中的临床价值

目的:探索四种血清肿瘤标记物对肝病的诊断及临床意义。方法:应用放射免疫法检测甲胎蛋白(AFP)、速率法检测岩藻糖苷酶(AFU)、血清β2微球蛋白(β2-MG)。测定原发性肝癌50例、肝硬化患者50例、其他恶性肿瘤患者50例、健康体检患者60例血清。结果:原发性肝癌各项指标与其他恶性瘤组、肝硬化组比较除β2-MG无差异(P>0.05)外,其他三项都有显著差别。分别(P<0.01)或有差异(P<0.05)。原发性肝癌组单项AFP、AFU、β2-MG、γ-GT。阳性检出率分别是66%、78%、80%、82%。AFP、AFU、γ-GT,诊断符合率分别是81%、84%、79%。联合检测敏感性达98%,比单项AFP(66%)检测敏感性比较差异有显著意义(P<0.01)结论:联合测定AFP、AFU、γ-GT,可提高对肝癌阳性诊断率,并可提高对肝病鉴别诊断价值。     

肿瘤标志物联合检测对原发性肝癌早期诊断的价值研究

目的:探讨肿瘤标志物联合检测对肝癌早期诊断的价值。方法:汇总原发性肝癌82例和肝硬化44例的AFP(甲胎蛋白)、GP73(高尔基体蛋白73)、AFPL3(甲胎蛋白异质体)、AFPL3/AFP及联合检测结果,结合临床资料进行对比分析。结果:原发性肝癌患者AFP、AFPL3、GP73、AFPL3/AFP阳性率均非常显著高于肝硬化患者(P<0.01);在早期和中期肝癌患者,采用多种肿瘤标志物联合检测,其阳性率非常显著高于各单项检测(P<0.01)。结论:肿瘤标志物联合检测对肝癌早期诊断的价值较高。     

血清AFU和AFP联合检测在原发性肝癌诊断中的应用

目的：探讨联合检测血清α-L-岩藻糖苷酶（AFU）和甲胎蛋白（AFP）对原发性肝癌的诊断意义。方法：选择2008-2010年间经综合检查确诊为原发性肝癌的住院患者30例,门诊健康体检者30例,早晨空腹采血分离血清,采用速率法测定AFU水平、化学发光法测定AFP水平,进行对比分析。结果：30例原发性肝癌患者中25例血清AFU活性增高,异常率为83.3%;20例AFP增高,异常率为66.7%;AFU和AFP联合检测,原发性肝癌的检出率为93.3%。30例健康对照组AFU和AFP的结果均在参考区间内,无异常。结论：血清AFU的测定对原发性肝癌的诊断具有重要价值,可用于原发性肝癌的诊断、疗效观察、手术后随访以及肝癌普查。AFU和AFP联合检测能提高原发性肝癌检查的敏感性、准确性,提高诊断率,减少漏诊。     

原发性肝癌患者血清Q-L-岩藻糖苷酶活力测定及临床应用价值

对原发性肝癌、肝内良性肿瘤及非肝癌其它恶性肿瘤、肝硬化患者共66例行血清Q-L-岩藻糖苷酶(AFU)和血清甲胎蛋白的测定,同时与60名健康人对照。结果原发性肝癌(PHC)组的AFU值(784.7±272.5μmol/L·h)显著高于正常组及其它各疾病组(P<0.01)。表明AFU活力测定对PHC的诊断、疗效观察有较大的临床观察意义,尤其是AFU与AFP联合检测可提高对PHC诊断的敏感性。     

AFP、CEA和CA199联合检测在原发性肝癌诊断中的应用

目的：探讨多种血清肿瘤标志物联合检测对原发性肝癌的诊断价值。方法：采集110例原发性肝癌和152例良性肝病（肝硬化和慢性肝炎）患者血液,用化学发光法测定AFP、CEA和CA199水平。结果：原发性肝癌患者血清中AFP、CEA和CA199水平分别为（60.6±80.5）μg/L、（22.2±13.9）μg/L、（47.2±28.3）U/L,明显高于良性肝病患者血清水平;原发性肝癌患者中AFP、CEA和CA199阳性率分别为74.6%、49.1%和45.5%,显著高于良性肝病患者;三者联合检测将原发性肝癌检测敏感率提升至92.7%。结论：联合检测可提高原发性肝癌诊断的敏感率,在原发性肝癌的筛查中有一定的应用价值。     

联合检测血清白细胞介素-6、铜蓝蛋白和甲胎蛋白对原发性肝癌的诊断价值

 目的 探讨联合检测血清白细胞介素-6、铜蓝蛋白和甲胎蛋白对原发性肝癌的诊断价值.方法 对40例健康人、32例肝硬化患者和48例原发性肝癌患者分别采用ELISA和电化学发光免疫法检测血清白细胞介素-6和甲胎蛋白含量;采用特种蛋白仪检测铜蓝蛋白含量,之后进行结果分析.结果 原发性肝癌患者中血清白细胞介素-6、铜蓝蛋白和甲胎蛋白阳性率分别为70.83%、66.67%和72.92%,显著高于对照组和肝硬化组 (P< 0.01).结论 与甲胎蛋白同时检测血清白细胞介素-6和铜蓝蛋白,对原发性肝癌的早期诊断具有重要价值.     

GP73联合AFP及GGT—Ⅱ检测对原发性肝癌的诊断价值

目的探讨联合检测高尔基体糖蛋白73（GP73）、甲胎蛋白（AFP）和γ-谷氨酰转移酶同工酶Ⅱ（GGT—Ⅱ）对原发性肝癌的诊断意义。方法分别采用化学发光免疫分析法、ELISA法和聚丙烯酰胺凝胶电泳法检测105例原发性肝细胞癌、60例肝硬化、72例乙型肝炎、30例肝良性肿瘤、90例HBV携带者和50例健康体检者血清中GP73、AFP和GGT-Ⅱ含量,分析GP73联合AFP、GGT-Ⅱ检测对原发性肝癌的诊断价值。结果原发性肝癌组GP73、AFP含量及GGT—Ⅱ阳性率明显高于良性肝病及正常对照组,差异有统计学意义（p〈0．05）;单独检测GP73、AFP和GGT-Ⅱ对诊断原发性肝癌的特异性分别为75．2％、84．8％和89．1％,敏感性分别为79．0％、57．1％、62．9％,联合检测GP73、AFP和GGT—Ⅱ可显著提高诊断原发性肝癌的敏感性（97．1％）。但特异性有所下降。结论联合检测GP73、AFP和GGT—Ⅱ作为诊断原发性肝癌的重要指标,可显著提高原发性肝癌的诊断率。     

血清α—L—岩藻糖苷酶、特异性肝癌蛋白、甲胎蛋白的联检在肝癌诊断中的价值

迄今,肝癌是恶性肿瘤中对人体造成威胁较大的疾病之一,但在诊断原发性肝癌(PHC)的血清学指标中,仍主要依赖甲胎蛋白(AFP)含量的测定。然而并非所有肝癌患者的肝细胞都分泌AFP。这使临床对PHC的早期诊断提供较可靠依据,我们对90例肝病患者进行了α—L—岩藻糖苷酶(AFU)、特异性肝癌蛋白(SHCSP)以及AFP的联检,并对其早期诊断PHC的价值进行了探讨。1 对象与方法1.1 对象 选择25名体检合格者,无肝功及肝脏的任何病变为正常对照组。PHC组47例,男性37例,女性10例,年龄41～72岁,并通过病理学、影象学及其它检测手段明确诊断者;肝硬化组36例,男性31例,女性5例,年龄42～79岁;肝脏良性病变组6例,男性4例,女性2例,年龄30～60岁。     

血清AFP、CA19-9、CA125、CEA、GGT联合检测对原发性肝癌的诊断价值

目的:探讨血清甲胎蛋白(AFP)、糖类抗原CA19-9、糖类抗原CA125、癌胚抗原(CEA)、γ-谷氨酰转肽酶(GGT)对原发性肝癌的诊断价值.方法:对39例原发性肝癌45例良性肝病及36名正常体检者血清AFP、CA19-9、CA125、CEA、GGT水平同步测定并进行对照.结果:AFP、CA19-9、CA125、CEA、GGT对原发性肝癌诊断的灵敏度依次为78.4%、70.3%、67.6%、48.6%和64.9%五项联合检测对原发性肝癌诊断的灵敏度可提高为94.6%.结论:多种肿瘤标志物联合检测对原发性肝癌的诊断具有重要价值.     

尿转化生长因子β1在原发性肝癌中的检测及临床意义

 目的探讨尿转化生长因子β1(TGF-β1)在原发性肝癌患者中的表达及临床意义.方法采用酶联免疫吸附试验法(ELISA)测定了88例原发性肝癌、40例肝硬化、40例慢性活动性肝炎及20例正常对照者尿中TGF-β1含量.结果原发性肝癌组患者尿TGF-β1水平明显高于肝硬化组、慢性肝炎组和正常对照组,组间的差异具有显著性意义(P＜0.01).以正常对照组患者尿TGF-β1含量x±2 s为阈值,尿TGF-β1诊断原发性肝癌的敏感性为65.9%,特异性为74.8%.肿块数目≥3个、直径≥3cm、AFP≤400μg/L的原发性肝癌患者尿TGF-β1水平明显增高.原发性肝癌患者尿TGF-β1水平与血清AFP相关性分析发现,r值为-0.22,P＜0.05,提示尿TGF-β1水平与血清AFP存在一定的负相关.10例原发性肝癌患者介入或手术治疗后尿TGF-β1水平明显下降(P＜0.01).结论尿TGF-β1可作为一种新的检测指标用于原发性肝癌的鉴别诊断和近期疗效的判断.     

肝动脉化疗栓塞术后联合射频热凝治疗大肝癌

目的探讨晚期原发性大肝癌(直径大于5cm)患者,先行肝动脉化疗栓塞(TACE),再行B超引导下经皮肝穿刺射频热凝(PRFA)治疗的疗效。方法分析我院2002年6月至2003年5月晚期原发性大肝癌患者62例,其中联合组32例,即先行TACE治疗,再行B超引导下PRFA治疗。TACE组30例,仅行TACE治疗。治疗后1个月定期检测甲胎蛋白(AFP)值,同时行CT、MRI或B超复查肿瘤坏死的情况。评价两组AFP值转阴率、1年生存率以及肿瘤完全坏死率。结果经过治疗后,联合组和TACE组AFP值转阴率分别为50．0％,42．8％(P=0．639)。1年生存率分别为37．5％,30．0％(P=0．243)。肿瘤完全坏死率分别为68．7％,40．0％(P=0．023)。两组间肿瘤完全坏死率有显著性差异,但两组间AFP值转阴率及1年生存率均无显著性差异。结论原发性大肝癌患者先行TACE治疗,再行PRFA治疗,较仅行TACE治疗,并不能延长患者的生存期。     

动态观察肝炎、肝硬化病人甲胎蛋白升高的临床意义

目的探讨动态检测和观察甲胎蛋白(AFP)在急、慢性肝炎、重型肝炎及肝炎后肝硬化中的意义。方法对184例肝炎及肝硬化患者用放免法检测AFP。初次发现AFP升高者分别作B超、CT检查,排除肝癌者每3个月复查1次AFP、肝功、B超,连续进行5年追踪随访。结果初次检测184例中除6例重型肝炎外,其他178例AFP均升高。随访中发现AFP稳定上升的3例均发展为肝癌;反复波动和持续低浓度的患者发生肝癌率分别4.2%和6.6%;一过性升高者均未出现肝癌。重症肝炎患者AFP越高病死率越低。结论AFP升高的肝炎与肝硬化患者动态检测观察AFP的变化,对早期发现肝癌有重要价值。     

Is anti-alphafetoprotein immunoscintigraphy a promising approach for the diagnosis of hepatoma?

The actual interest of immunoscintigraphy for the detection of liver tumours was investigated by both visual examination and quantitative analysis in 41 patients with hepatoma (HCC, 21 cases, 13 AFP-secreting), other primary or secondary liver cancer (9 cases), testicular cancer (2 cases) and cancer free cirrhosis (9 cases). All patients were injected with ¹²³I-anti-alphafetoprotein (AFP) monoclonal antibodies (MAbs) and scans were performed after 28±2 h. In the hepatoma-bearing patients, 11 positive anti AFP scans were found; 9 of them had an enhanced serum; besides, 3 non HCC tumours were also detected. With respect to hepatoma diagnosis, sensitivity was 52.5% and specificity 66.5%. For all hepatomas, it was striking that the positivity rate was 2/10 and 9/11, respectively, when HCC was and was not associated with cirrhosis. Among 6 patients with a positive anti AFP scan who were also injected with control anti hCG ¹²³I-MAb, 5 positive anti hCG scans were surprisingly found, with specificity indices ranging between 1.00 and 1.75. The quantitative study also highlighted the importance for hepatoma detection of specific and non specific factors such as serum AFP, tumoural vascularization, non tumoural liver uptake and intrahepatic distribution of HCC.Anti AFP immunoscintigraphy appears as a poorly sensitive and moderately specific method for hepatoma diagnosis. In contrast, non tumoural liver uptake level could be more useful for discriminating HCC from liver metastases and perhaps to detect the early extension of HCC.This work was partly supported by the ARC grant nr 6265     

原发性肝癌肝动脉化疗栓塞联合生物治疗的价值

目的 评价肝动脉化疗栓塞联合生物治疗对原发性肝癌的疗效。方法 56例原发性肝癌被随机分为两组:接受肝动脉化疗栓塞联合生物治疗的28例为观察组,只接受肝动脉化疗栓塞的28例为对照组。两组在治疗后半年、1年、2年的疗效与生存率分别作X~2检验,进行对照分析。结果 观察组的总有效率为67.8％(19/28)。而对照组为53.6％(15/28),两组间无显著性差异(X~2=1.20,P>0.05);半年、1年、2年时的生存率观察组分别为92.9％(26/28)、39.3％(11/28)和14.3％(4/28),而对照组分别为71.4％(20/28),14.3％(4/28)和0,两组分别比较有显著性差异(X~2值分别为4.38,4.46,4.30,P值均小于0.05)。结论 就原发性肝癌的保守治疗而言,肝动脉化疗栓塞联合生物治疗的效果期明显优于单纯肝动脉化疗栓塞。     

Is anti-alphafetoprotein immunoscintigraphy a promising approach for the diagnosis of hepatoma? Implications of a quantitative study in 41 patients

The actual interest of immunoscintigraphy for the detection of liver tumours was investigated by both visual examination and quantitative analysis in 41 patients with hepatoma (HCC, 21 cases, 13 AFP-secreting), other primary or secondary liver cancer (9 cases), testicular cancer (2 cases) and cancer free cirrhosis (9 cases). All patients were injected with 123I-anti-alphafetoprotein (AFP) monoclonal antibodies (MAbs) and scans were performed after 28 +/- 2 h. In the hepatoma-bearing patients, 11 positive anti AFP scans were found; 9 of them had an enhanced serum; besides, 3 non HCC tumours were also detected. With respect to hepatoma diagnosis, sensitivity was 52.5% and specificity 66.5%. For all hepatomas, it was striking that the positivity rate was 2/10 and 9/11, respectively, when HCC was and was not associated with cirrhosis. Among 6 patients with a positive anti AFP scan who were also injected with control anti hCG 123I-MAb, 5 positive anti hCG scans were surprisingly found, with specificity indices ranging between 1.00 and 1.75. The quantitative study also highlighted the importance for hepatoma detection of specific and non specific factors such as serum AFP, tumoural vascularization, non tumoural liver uptake and intrahepatic distribution of HCC. Anti AFP immunoscintigraphy appears as a poorly sensitive and moderately specific method for hepatoma diagnosis. In contrast, non tumoural liver uptake level could be more useful for discriminating HCC from liver metastases and perhaps to detect the early extension of HCC.     

原发性肝癌介入化疗栓塞治疗术前后血清总胆汁酸测定的价值

目的　探讨血清总胆汁酸(TBA)检测在原发性肝癌介入治疗围手术期肝功能储备及预后评价的价值。方法　分析1 6 0例接受动脉介入化疗栓塞的原发性肝癌患者围手术期血清TBA水平与肝功能损伤程度、肝硬化、介入治疗方式及术后肝功能衰竭的关系。结果　1 6 0例肝癌患者术前血清TBA值较正常对照组明显升高(P <0 .0 1 ) ,ChildA级相似文献   

结肠灌注透析治疗失代偿期肝硬化顽固性腹水及低钠血症的近期疗效分析

目的研究结肠灌注透析对失代偿期肝硬化顽固性腹水及低钠血症的治疗效果。方法将58例失代偿期肝硬化顽固性腹水患者随机分为治疗组(30例)和对照组(28例),两组均给予限钠、限水、护肝、利尿等基础治疗,治疗组联合使用结肠灌注透析治疗,比较两组治疗前后各相关指标。结果治疗组腹水治疗有效率为86.7%,对照组为64.3%。两组比较,差异有统计学意义(P<0.05);治疗组血清钠复常率53.3%,对照组为32.1%。两组比较,差异有统计学意义(P<0.05)。结论结肠灌注透析治疗对失代偿期肝硬化顽固性腹水及低钠血症均有较好的近期疗效。