甲胎蛋白异质体L3预警原发性肝癌的研究

目的 探讨甲胎蛋白异质体(AFP-L3)的检测在预警原发性肝癌中的作用.方法 对100例AFP升高肝病患者血清,应用甲胎异质体微量离心柱分离并洗脱获得AFP-L3,再同时检测原始血清中的AFP以及AFP-L3含量,计算AFP-L3在AFP中的比例,对AFP-L3异常升高者、正常者进行跟踪,结合6个月后临床诊断结果 ,分析AFP-L3升高在鉴别良性肝脏病变与预警肝癌中的作用.结果 肝癌、疑似肝癌患者与良性肝病患者中的AFP-L3阳性率差异有统计学意义(分别为81.80%、73.68%、11.80%,P＜0.05).未确诊肝癌(疑似HCC、肝病)的患者中,AFP-L3阳性的21例中有12例在6个月内被诊断为HCC,而且有6例是通过B超、CT等影像学手段被早期确诊的单发性小肝癌.AFP-L3阴性的62例标本中,6个月内有3例发生肝癌,AFP-L3阳性发生肝癌的危险率增加了11.9倍.结论 AFP-L3与AFP值无相关性,可以作为一个独立肝细胞癌诊断因子.AFP-L3的测定对于AFP升高时良、恶性肝病的鉴别及肝癌的早期预警诊断具有重要意义.

The studies on early warning of Lens culinaris-reactive α-Fetoprotein (AFP-L3) detecting in primary hepatocellular carcinoma

Objective To explore the significance of Lens culinaris-reactive α-Fetoprotein (AFP-L3) detection in primary hepatocellular carcinoma. Methods AFP-L3 was isolated by using microspincolumn coupled with lens culinaris agglutinin (LCA), AFP and AFP-L3 were detected with chemiluminescent immunoassay, the propertion of AFP L3 levels were calculated, and the relationship between the elevated AFP-L3 (%) levels and benign and malignant liver disease was analyzed. Results There were significant differences in positive rate between the patients of HCC, suspected HCC and other liver disease (81.80%, 73.68%, 11.80%, respectively, P ＜ 0.05). Among the undetermined HCC (suspected HCC, liver disease) patients, 12 out of 21 cases of AFP-13 positive were diagnosed to be HCC within 6 months, and 6 of them were diagnosed to be the single small HCC at the early stage through B-Ultrasonic Diagnosis or CT. Among 62 cases of AFP-L3 negative, 3 cases were diagnosed to be HCC within 6 months and the risk of occurrence of HCC for AFP-L3 positive increased 11.9 times. Conclusion AFP-L3 has no correlation with AFP value, and it can be used as an independent HCC diagnosis factor. The detection of AFP-L3 has a significant implication for the identification of benign or malignant liver disease and the early stage predictive diagnosis of HCC while AFP increases