血清AFP-L3与GP73联合检测对AFP低浓度肝癌的诊断价值

目的探讨甲胎蛋白异质体（AFP-L3）与高尔基体蛋白73（GP73）联合检测在低浓度AFP肝癌诊断中的价值。方法收集近3年在该院进行治疗的低浓度AFP肝病患者224例临床资料和血清学检测作为研究。依据肝病种类分为肝癌组（n=112）,肝硬化组（n=67）,肝炎组（n=45）。选择同时期健康体检中心进行健康查体者63例作为对照组,酶联免疫吸附法（ELISA）检测各组GP73的表达情况;应用甲胎蛋白异质体亲和吸附离心管洗脱获得,同时化学发光法检测原始血清中总AFP和AFP-L3,计算AFP-L3在总AFP中的比率。结果肝癌组AFP-L3和GP73水平均显著高于肝硬化组、肝炎组、对照组,差异具有统计学意义（P〈0.05）。肝癌组患者中AFP-L3和GP73阳性率均显著高于肝硬化组、肝炎组、对照组,差异具有统计学意义（P〈0.05）。肝癌组患者GP73阳性率显著高于AFP-L3阳性率,差异具有统计学意义（P〈0.05）。采用AFP-L3和GP73联合检测的灵敏度和准确度最高,差异具有统计学意义（P〈0.05）。结论 AFP-L3与GP73均可作为诊断低浓度AFP肝癌的血清标记物,二者联合检测具有更高的灵敏度和准确性,可提高低浓度AFP肝癌的诊断率。

Diagnosis value on combined detection of serum AFP-L3 and GP73 in primary liver cancer with low level of AFP

Objective To analyze the clinical values of alpha-fetoprotein-L3（AFP-L3）and golgiprotein73（GP73）in diagnosing primary liver cancer with low level of AFP.Methods The affinity microcentrifugalcolumn method and enzyme-linked immunosorbent assay were employed to detect the serum level of AFP-L3and GP73in 112cases of primary liver cancer,67cases of liver cirrhosis,45cases of chronic hepatitis B and 63healthy controls.The level of AFP with all patients were low.The proportion of AFPL3/AFP（%）was calculated in the following analyses.Results Serum level of AFP-L3（%）and GP73were significant higher in primary liver cancer with low level of AFP group than other groups（P〈0.05）.The positive rate of AFP-L3（%）and GP73were significant higher in liver cancer group with low level of AFP than other groups（P〈0.05）.The sensitivity and accuracy of combined detection of the two parameters were significant higher than detection of only one parameter（P〈0.05）.Conclusion Both serum AFP-L3（%）and GP73can be use as biomarkers in the diagnosis of primary liver cancer with low level of AFP.Combine detection can improve diagnostic accuracy,with a higher sensitivity in diagnosing primary liver cancer with low level of AFP.