亲和吸附胶体金免疫层析检测甲胎蛋白变异体方法的建立及应用

目的建立一种简便、快速检测甲胎蛋白变异体（AFP—L3）的新方法。方法用离心柱亲和吸附结合胶体金测试条检测1350例血清标本中AFP-L3（110例正常体检人员、550例慢性乙肝、350例肝硬化、320例肝细胞肝癌和20例脐带）。结果脐带血AFP—L3均为阴性。189例AFP升高的肝癌患者中AFP—L3有153例（81．0％）为阳性，其中AFP〈400ng／mll〉20ng／ml的患者中AFP—L3检出率为34．2％（13／38），〉400ng／ml患者中AFP—L3检出率为92．7％（140／151）。结论AFP-L3检测可预警肝癌的发生，主要特点为：不受AFP〉400ng／ml作为肝癌诊断标准的限制；不受影像学检查结果为阴性的束缚；有助于鉴别影像学检查难以确诊的肝占位性病变；从而可缩短肝癌的诊断时间。借助AFP—L3与AFP检测值的对比，判断患者手术治疗是否彻底，从而为后续治疗提供重要参考依据。

Establishing and Applying the Method of Affinity Adsorption Aerosol Immunization Chromatography Detecting AFP- L3

Objective To establish a new, simple and quick method to detect AFP-L3. Method The centrifugal column affinity adsorption combined aerosol test strip was used to detect AFP-L3 in the serum of 1350 cases （110 cases were the people screened, 550 patients with chronic hepatitis, 350 with cirrhosis, 320 with hepatocellular carcinoma, and 20 cord blood ）. Results AFP-L3 of cord blood was negative. AFP-L3 in 153 cases （81.0%） was positive among 189 hepatocellular carcinoma patients whose AFP was high. Among of them, the detection rate of AFP-L3 was 34.2% （13/38） of the patients whose AFP〈400ng/mll〉20ng/ml, while the detection rate of AFP-L3 was 92.7% （140/151） of the patients whose AFP〉400ng/ml. Conclusion AFP-L3 can predict the occurrence hepatocellular carcinoma. The feature is that the method is not restricted by AFP〉400ng/ ml as the indicator for diagnosing hepatocellular carcinoma, is not limited by the negative result of image test and is helpful to distinguish liver occupancy pathologic change which the image test is hard to find out so that it can short the time to diagnose the hepatocellular carcinoma. With the aid of comparing the test result of AFP-L3 with that of AFP, the operation therapy is judged whether is successful completely or not so that it can provide the important evidence for later treatment.