甲胎蛋白异质体测定在原发性肝癌和良性肝病鉴别诊断中的应用分析

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1、甲鱷白异质体昵良细中的師分析2018-04-0809:50:18中国现代医生2018年4期李晓峰王其童涌［摘要］戸的分析甲胎蛋白(^fetoprotein,AFP)异质体测定在原发性肝癌和良性肝病鉴别诊断中的应用价值。方法选择2016年3月〜2017年4月本院收治的慢性乙型肝炎病毒患者104例作为研究对象，其中包括原发性肝癌53例，各类良性肝病患者51例：所有患者均进行微量离心柱法分离小扁豆凝集素结合型AFP-L3(甲胎蛋白异质体、AFP・L3、AFP-L3variant)测定，并通过实施化学发光法测定甲胎蛋白含量、AFP-L3水平

2、及AFP丄3占总甲胎蛋白的比率。检测后所有检测结果均以AFP-L3>10%为阳性作为诊断标准、AFP>400ng/mL为阳性作为判断标准。结果53例原发性肝癌患者中,AFP-L3>10%43例(81.1%)；51例各类慢性肝病患者中,AFP-L3>10%5例(9.8%),肝癌AFP-L3陽性率明显高于良性肝病阳性率(PvO.05)。53例原发性肝癌患者屮，AFP>400ng/mL33例(62.3%)；51例各类慢性肝病患者中,AFP>400ng/mL14例(27.5%),肝癌AFP阳性率明显高于良性肝病阳性率(Pv0.05)o肝癌患

3、者AFP-L3>10%.AFP>400ng/mL比较差异不明显(P>0.05)o结论在原发性肝癌和良性肝病鉴别诊断屮，通过甲胎蛋白异质体测定，能有效区分肝癌与良性肝病，弥补AFP诊断中的不足之处，具有--定的临床诊断实用性，值得临床推广应用。［关键词］甲胎蛋口异质体测定；原发性肝癌；良性肝病；鉴別诊断价值［中图分类号］R735.7［文献标识码］A［文章编号］1673-9701(2018)04-0005-03［Abstract］ObjectiveToanalyzetheapplicationvalueofAFPfetoprotein)

4、heterogeneityinthedifferentialdiagnosisofprimarylivercancerandbenignliverdisease・MethodsAtotalof104patientswithchronichepatitisBvirusadmittedinourhospitalfromMarch2016toApril2017wereselected,ineluding53patientswithprimarylivercancerand51patientswithvarioustypesofbenign

5、liverdisease・AllpatientsunderwentmicrocentrifugecolumnmethodtoIsolatelentillectin-bindingAFP-L3(alpha-fetoproteinheterogeneity,AFP-L3,AFP-L3variant)・Thealpha-fetoproteincontent,theAFP-L3levelandtheratioofAFP-L3tototalalpha-fetoproteinweredeterminedbychemiluminescenceas

6、say.Afterdetection,theAFP-L3>10%wasasapositivediagnosticcriteriaandtheAFP>400ng/mLwasasapositivestandard・ResultsOfthe53patientswithprimarylivercancer,therewere43patientswithAFP-L3>10%(81.1%).In51patientswithchronicliverdisease,therewere5patientswithAFP-L3>10%(9.8%)・The

7、positiverateofAFP・L3inhepatocellularcarcinomawassignificantlyhigherthanthatinbenignliverdisease(P<0.05).Therewere33patientswithAFP>400ng/mL(62.3%)in53patientswithprimarylivercancer.Therewere14patientswithAFP>400ng/mL(27.5%)in51casesofchronicliverdisease.AFPpositiverate

8、oflivercancerwassignificantlyhigherthanthatofbenignliverdisease(P<0.05).TherewerenosignificantdifferencesinAFP-L3>10%