AFP AFU GPC3联合检测在原发性肝癌诊断中的应用

目的:探讨三种血清肿瘤标志物甲胎蛋白(AFP)、α-L岩藻糖苷酶(AFU)、磷脂酰肌醇蛋白聚糖3(GPC3)单独及联合检测对原发性肝癌(PHC)的互补诊断价值。方法:对我院2009年8月至2011年7月收治的55例PHC,30例肝硬化患者进行单独及联合检测AFP、GPC3、AFU。采用电化学发光法测定AFP水平,速率法检测AFU水平,ELISA法检测GPC3水平。结果:PHC组血清GPC3、AFU和AFP水平均明显高于肝硬化组,差异有统计学意义(P<0.05)。PHC患者血清GPC3、AFU和AFP阳性率分别为47.3%、23.6%、29.1%。血清指标AFP联合AFU或者AFP联合GPC3可使检出率分别提高至38.2%和63.6%。三项指标联合检测PHC的阳性率可高达78.1%。AFP阴性的39例PHC患者中,血清GPC3、AFU阳性率分别为60.0%(23/39)、30.8%(12/39),表明二者对AFP阴性的PHC患者具有较高的诊断互补作用。结论:血清肿瘤标志物AFP、AFU、GPC3对PHC有一定的诊断价值;血清GPC3和AFP联合检测可明显提高PHC的诊断率,优于单项检测,特别是AFP阴性或AFP呈低浓度对PHC更具有诊断价值。

Study on Combined Detection of AFP AFU and GPC3 in the Diagnosis of Primary Hepatic Cancer

Objective: To study the complementary value of alpha-fetoprotein(AFP),α-L-fucosidase(AFU) and glypican3(GPC3) to the diagnosis of primary hepatic carcinoma(PHC).Method: AFP,AFU and GPC3 in serum were measured in 55 cases of primary hepatic carcinoma and 30 liver cirrhosis patients in our hospital from Aug.2009 to Jul.2011.The three indices were compared and analyzed for the their complementary diagnostic values to primary hepatic carcinoma.Used electrical spectrophotometer method to detect AFP,speed method to detect AFU and enzyme-linked immunosorbent assay method to detect GPC3.Result: AFP,AFU and GPC3 in PHC group were significantly higher than the other two groups(P<0.05).The positive detection rate of GPC3,AFU and AFP in PHC group was 47.3%,23.6%,29.1% respectively.Simultaneous determination of AFP and AFU or GPC3 could increase the sensitivities to 38.2% or 63.6% respectively.Furthermore,combines detection of these three indices could make the diagnostic sensitivities as high as 78.1%.In 39 PHC cases whose AFP was negative,the positive detection rate of GPC3 and AFU was 60.0%(23/39)and 30.8%(12/39) respectively,it may manifest the complementary function.Conclusion: There is diagnostic value of AFP,AFU,GPC3 on PHC.The combining of examination in AFP and GPC3 is superior,especially in those with negative or low serum level of AFP.