CAJ | 학술논문

目的探讨微量离心柱法检测甲胎蛋白异质体（AFP-L3）在肝癌预警及良恶性肝病鉴别诊断中的临床应用价值。方法使用装有耦联小扁豆凝集素（LCA）的甲胎蛋白异质体（AFP-L3）亲和吸附离心管分离原发性肝癌组、肝硬化组和慢性肝炎组共183例患者血清甲胎蛋白异质体（AFP-L3），采用郑州安图LUMO化学发光分析仪检测分离前AFP和分离后AFP（AFP-L3），计算AFP-L3占 AFP 总量的百分比[AFP-L3（%）]。结果①原发性肝癌组AFP-L3均值和阳性率明显高于肝硬化组和慢性肝炎组(P<0.001)；低浓度AFP（AFP＜200μg/L）原发性肝癌组AFP-L3也明显高于肝硬化组和慢性肝炎组(P<0.01)。②在原发性肝癌组中，不同浓度AFP均值和阳性率相比，差异无统计学意义(P>0.05)。结论应用新型亲和离心柱法检测甲胎蛋白异质体（AFP-L3）在肝癌与良性肝病的诊断中具有重要意义，尤其对低浓度原发性肝癌和良性肝病的鉴别诊断具有重要的临床价值。
목적탐토미량리심주법검측갑태단백이질체（AFP-L3）재간암예경급량악성간병감별진단중적림상응용개치。방법사용장유우련소편두응집소（LCA）적갑태단백이질체（AFP-L3）친화흡부리심관분리원발성간암조、간경화조화만성간염조공183례환자혈청갑태단백이질체（AFP-L3），채용정주안도LUMO화학발광분석의검측분리전AFP화분리후AFP（AFP-L3），계산AFP-L3점 AFP 총량적백분비[AFP-L3（%）]。결과①원발성간암조AFP-L3균치화양성솔명현고우간경화조화만성간염조(P<0.001)；저농도AFP（AFP＜200μg/L）원발성간암조AFP-L3야명현고우간경화조화만성간염조(P<0.01)。②재원발성간암조중，불동농도AFP균치화양성솔상비，차이무통계학의의(P>0.05)。결론응용신형친화리심주법검측갑태단백이질체（AFP-L3）재간암여량성간병적진단중구유중요의의，우기대저농도원발성간암화량성간병적감별진단구유중요적림상개치。
Objective: To explore the clinical value of Lens culinaris agglutinin-reactive alpha-fetoprotein in the differentiation diagnosis between benign and malignant liver diseases, as well as the early warning of hepatocellular carcinoma. Methods:The micro spin column coupled with lens culinaris agglutinin (LCA) was used to isolate the AFP-L3 from the serums of 183 patients with chronic hepatitis, cirrhosis and primary liver cancer .AFP and AFP-L3 were determined by auto LuMo chemiluminescence Immunoassay Analyzer,and the proportion of AFP-L3 LevelAFP-L3(%)]were calculated. Results :The positive rate and the mean level of AFP-L3 either in the patients with primary liver cancer or in the patients with primary liver cancer whose AFP(<200μg/L) were statistic significantly different from the patients with chronic hepatitis or cirrhosis of liver (p<0.001). However ,in the groups of primary liver cancer,there was no significant difference of the serum mean level and the positive rate of AFP-L3 among the groups of different AFP concentration (P>0.05). Conclusion: The new method to detect AFP-L3 with micro spin column shows important clinical value in the diagnosis of liver cancer and benign liver disease,and it may be especially important for the differential diagnosis between the patients with primary liver cancer whose AFP level is low and the patients with benign liver disease.