甲胎蛋白异质体L3对低浓度甲胎蛋白肝癌诊断的临床意义.pdf

《甲胎蛋白异质体L3对低浓度甲胎蛋白肝癌诊断的临床意义.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、452中华实验和临床病毒学杂志2013年12月第27卷第6期ChineseJExpClinVirol，December2013，Vo1．27，No．6病毒病诊断与治疗．甲胎蛋白异质体L3对低浓度甲胎蛋白肝癌诊断的临床意义李鲁平，谷海峰，陈霖，刘爱霞，刘佳，徐军，张健，郭静霞，赵静，李伯安【摘要】目的探讨在低浓度甲胎蛋白(AFP)肝病患者中，甲胎蛋白异质体L3(AFP·L3)的百分含量(AFP—L3％)对肝癌的早期诊断和疗效评估的临床意义。方法收集245例血清低AFP含量(5～40ng／m1)的肝病患者样本(其中肝硬化

2、患者100例、肝癌患者145例)，检测AFP—L3％，并对其中100例肝硬化患者和20例肝癌术后患者分别进行3个月和12个月的随访。结果以AFP—L3％≥10％作为阳性判断标准，100例肝硬化患者中阳性为23例，经3个月随访后其中8例诊断为肝癌；145份肝癌患者血清AFP．L3％阳性率为46．2％(67／145)。低浓度AFP肝癌组的AFP—L3％水平显著高于低AFP肝硬化组(t：7．318，P=0．001<0．01)；20例肝癌患者术后有5例AFP-L3％仍为阳性，其在12个月内的生存率为0，而术后AFP—L3％阴

3、性患者生存概率为15／15。结论AFP—L3％在低浓度AFP肝病患者中对肝癌的早期诊断和术后疗效评估都具有一定的临床意义。【主题词】甲胎蛋白类；肝肿瘤；诊断，鉴别Thediagnosticvalueofhepat0ceUularcarcinomabyAFP-L3variantdeterminedinAFPlowconcentrationsLILu-ping，GUHai母ng，CHENLin．LIUAi—xia，LIUJia，xUJun，ZHANGJian，GUOJing-xia，z0ring，L1Be-an．eSix

4、thPeople'sHospitalofShenyang，Liaoning110006，ChinaCorrespondingauthor：LIBe—an，Email：fba@263．net【Abstract】0bjectiveToexploretheclinicalvalueofalpha—fetoproteinvariant(AFP—L3)percentageintheearlydiagnosisofhepatocellularcarcinoma(HCC)andtheoperationevaluationinthe

5、patientswithlowserumAFPleve1．MethodsAFP—L3variantsfrom245patients(includinglO0casesofcirrhosisand145casesofHCC)withlowserumAFP1evel(5_40ng／m1)wereisolatedandthecontentsofAFP—L3variantandtotalserumAFPweremeasuredtogetAFP—L3％(theratioofAFP—L3tototalAFP)．Thefoflow

6、—uPof3monthsfor1O0cirrhosispatientsand12monthsfor20HCCpatientswhounderwentoperationwereperformed．ResultsUsingAFP—L3％≥1O％asapositivecriterion．therewasapositiverateof23％withAFP—L3％in100casesofcirrhosis．and8outof23casesofAFP—L3positivewerediagnosedtobeHCCafter3mon

7、ths．Therewasapositiverateof46．2％withAFP—L3％in145casesofHCCwithlowserumAFPleve1．AFP—L3％leve1wassignificantlyhigherinHCCthanthoseincirrhosisft=7．3l8．P=0．001<0．01)．TheresultsofAFP—L3％0f20HCCpatientswhounderwentoperationandtherapyshowedthatthesurvivalratesofAFP．L3％

8、positivecasesat12monthswas0．andthesurvivalratesofAFPL3％negtivecasesat12monthswasl5／15．ConclusionThepercentageofAFP—L3hassignificantclinicalvaluesfortheearlydiagnosisofHCCand