血清铁蛋白、甲胎蛋白和甲胎蛋白异质体联合检测对原发性肝癌诊断的临床意义

目的 探讨血清铁蛋白（Fer）、甲胎蛋白（AFP）、甲胎蛋白异质体（AFP-L3）联合检测对原发性肝癌的诊断价值.方法 健康对照组84名、原发性肝癌组92例、良性肝病组45例均同时检测血清Fer、AFP、AFP-L3.结果 原发性肝癌组血清Fer检测结果为（819.4±616.8）μg/L,AFP为（556.9±451.5）μg/L,AFP-L3为（109.0±62.5） μg/L,良性肝病组Fer检测结果为（229.3±155.5） μg/L,AFP为（6.0±4.2） μg/L,AFP-L3为（26.0±49.4） μg/L,健康对照组Fer检测结果为（125.6±110.5）μg/L,AFP为（2.8±0.8） μg/L,AFP-L3为（7.0± 1.8）μg/L,三者差异有统计学意义（均P＜0.01）.原发性肝癌组单独检测血清Fer的敏感度为85.9％,AFP的敏感度为71.0％,AFP-L3的敏感度为83.7％,联合检测Fer和AFP或AFP-L3可使检测敏感度提高到90.2％和95.7％,三者联合检测敏感度为98.9％.结论 联合检测血清Fer、AFP、AFP-L3三项指标可以提高原发性肝癌的诊断准确率.

Diagnostic value of serum Fer,AFP and AFP-L3 combined detection in primary hepatic cancer

Objective To evaluate the diagnostic value of the combined detection of serum Fer,AFP and AFP-L3 in patients with primary hepatic cancer （PHC）.Methods The serum levels of Fer,AFP and AFP-L3 were determined in 92 patients with PHC,84 patients with benign liver disease,and 45 control subjects.Results The PHC group serum Fer was （819.4±616.8） μg/L,AFP was （556.9±451.5） μg/L,AFP-L3 was （109.0±62.5） μg/L.The benign liver disease group Fer was （229.3±155.5） μg/L,AFP was （6.0±4.2） μg/L,AFP-L3 was （26.0±49.4） μg/L.The healthy control group Fer was （125.6±110.5） μg/L,AFP was （2.8±0.8） μg/L,AFP-L was （7.0±1.8） μg/L,there was significant difference between the three groups （all P ＜ 0.01）.The sensitivity of PHC group alone in detection of serum Fer was 85.9 ％,the sensitivity of AFP was 71.0 ％,the sensitivity of AFP-L3 was 83.7 ％,the combined detection of Fer and AFP or AFP-L3 improved the sensitivity of the test to 90.2 ％ and 95.7 ％,the three combined detection sensitivity was 98.9 ％.Conclusion Combined detection of serum Fer,AFP and AFP-L3 is essential in the diagnosis of PHC.