血清GGT、AFP和AFP-L3联合检测对原发性肝癌诊断的临床意义

目的 探讨r-谷氨酰转移酶(GGT)、血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)联合检测对原发性肝癌诊断的诊断价值.方法 正常健康对照组84例,原发性肝癌组92例,良性肝病组45例,均同时检测血清GGT、AFP、AFP-L3.结果 原发性肝癌组血清GGT、AFP、AFP-L3与良性肝病组、正常健康对照组比较,差异有统计学意义(P＜0.01).原发性肝癌组血清GGT、AFP、AFP-L3单独检测时的敏感性分别75.5％、71.0％和83.7％,联合检测GGT和AFP或AFP-L3可使检测敏感性提高到79.3％和88.7％,三者联合检测敏感性为93.1％.结论 联合检测GGT、AFP、AFP-L3 3项指标可以大大提高原发性肝癌的诊断率.

Value of detection of Serum AFP, AFU and CEA in diagnosis of primary hepatic cancer

Objective To evaluate the value of detection of serum GGT,AFP and AFP-L3 in diagnosis of primary hepatic cancer（ PHC）. Methods The serum levels of GGT, AFP and AFP-L3 in 92 patients with PHC, 84 patients with liver cirrho- sis, and 45control subjects were determined and analyzed. Results Serum levels of GGT, AFP and AFP-L3 in patients with PHC were all signifieandy higher than the control subjects and the patients with liver cirrhosis （ P〈0.01）. The sensitivity of di- agnosis of PHC was 75.5%, 71.0%, and 83.7%, respectively, when GGT, AFP, and AFP-L3 were individually detected. The ac- curacy could be increased to 79.3% （ combined detection of GGT and AFP） and 88.7% （ combined detection of GGT and AFP-L3）. The accuracy was further increased to 93.1% when all GGT, AFP and AFP-L3 were detected. Conclusion Com- bined detection of serum GGT,AFP and AFP-L3 is greatly enhance the sensitivity in diagnosis of PHC, especially in AFP nega- tive patients.