原发性肝癌病人AFP-L3、AFU、GP73及TSGF等血清标志物的水平分析及临床意义

目的 评价血清甲胎蛋白异质体(AFP-L3)、α-L-岩藻糖苷酶(AFU)、高尔基体糖蛋白73(GP73)及肿瘤特异性生长因子(TSGF)四者联合在原发性肝癌(PHC)诊断中的价值.方法 选取2015年3月至2016年3月间我院收治的90例PHC患者作为观察组,并选择同一时期收治的45例肝炎肝硬化患者作为疾病对照组,及45例健康志愿者作为健康对照组.采取微量离心法分离血清AFP-L3,然后检测其占总甲胎蛋白(AFP)的百分比,生化定量法测三组血清AFU、TSGF水平,以及酶联免疫法(ELISA)测三组血清GP73水平.结果 观察组血清AFP-L3、AFU、GP73及TSGF水平均明显高于疾病对照组与健康对照组,差异有统计学意义(P＜0.05);观察组上述四种指标单独及联合检测的阳性率均显著高于疾病对照组与健康对照组的检测阳性率,差异有统计学意义(P＜0.05);同时AFP-L3、AFU、GP73及TSGF检测的灵敏度分别为58.9％、72.2％、74.4％、64.4％,特异性分别为90.0％、75.6％、76.7％、81.1％,准确度分别为74.4％、73.9％、75.6％、72.8％,而四者联合的灵敏度、特异性及准确度分别为92.2％、96.7％、94.4％,联合检测明显高于各指标单独检测,差异有统计学意义(P＜0.05).结论 血清AFP-L3、AFU、GP73及TSGF联合检测能够显著增强检测的灵敏度及特异性,提高PHC的检出率.

Analysis and Clinical Significance of Serum Markers of TSGF,AFU,GP73 and AFP-L3 in Patients with Primary Liver Cancer

Objective To evaluate the diagnosis value of combined four markers of alpha fetal protein heterogeneity (AFP anti-L3),alpha L fucosidase (AFU) and Golgi protein 73 (GP73) and tumor specific growth factor(TSGF) in primary hepatocellular carcinoma(PHC).Methods We selected 90 PHC patients in our hospital as the observation group,45 cases of hepatitis cirrhosis as the control group,and 45 healthy volunteers as normal control group.We isolated AFP-L3,measured the percentage of AFP-L3/total alpha fetal protein (AFP).The serum levels of AFU,TSGF and GP73 were determined by biochemical and enzyme linked immunosorbent assay (ELISA).Results The serum levels of AFP-L3,AFU,GP73 and TSGF in the observation group were significantly higher than those in the control group and healthy control group (P ＜ 0.05).The positive rates of the four indexes in the observation group were significantly higher than those of the control group and the healthy control group (P ＜ 0.05).At the same time,the sensitivity of AFP-L3,AFU,GP73 and TSGF were 58.9％,72.2％,74.4％ and 64.4％.The specificity was 90％,75.6％,76.7％ and 8t.1％.The accuracy was 74.4％,73.9％,75.6％ and 72.8％.However,the sensitivity,specificity and accuracy of the combined detection were 92.2％,96.7％ and 94.4％.The combined detection was significantly higher than that of each index (P ＜ 0.05).Conclusion The combined detection of serum AFP-L3,AFU,GP73 and TSGF can significantly enhance the detection sensitivity and specificity,and improvethe detection rate of PHC.