CAJ | 학술논문

目的：探讨微量离心柱法检测血清甲胎蛋白（AFP）异质体（AFP-L3）在肝癌诊断及良、恶性肝病鉴别诊断中的临床应用价值。方法选择2011年6月至2012年10月于阳山县人民医院就诊的原发性肝癌（PLC）患者80例（PLC组）、肝硬化患者66例（肝硬化组）和慢性肝炎患者54例（慢性肝炎组）作为研究对象，应用国产微量离心柱法试剂分离纯化血清AFP-L3，采用化学发光法检测血清AFP和AFP-L3水平，并计算 AFP-L3在总AFP中所占比例（AFP-L3％）。结果PLC组患者血清AFP、AFP-L3％水平均高于肝硬化组和慢性肝炎组（P＜0．05）。以AFP＞25 ng/mL ，AFP-L3％≥10％作为阳性判断标准，PLC组患者血清AFP阳性率高于肝硬化组和慢性肝炎组，且PLC组患者血清AFP-L3％阳性率亦明显高于肝硬化组和慢性肝炎组（P＜0．05），但具有不同血清AFP水平的PLC患者之间，血清AFP-L3％水平和阳性率比较差异均无统计学意义（P＞0．05）。结论微量离心柱法检测血清AFP-L3％在肝癌的早期诊断和良、恶性肝病的鉴别诊断中具有重要价值。
목적：탐토미량리심주법검측혈청갑태단백（AFP）이질체（AFP-L3）재간암진단급량、악성간병감별진단중적림상응용개치。방법선택2011년6월지2012년10월우양산현인민의원취진적원발성간암（PLC）환자80례（PLC조）、간경화환자66례（간경화조）화만성간염환자54례（만성간염조）작위연구대상，응용국산미량리심주법시제분리순화혈청AFP-L3，채용화학발광법검측혈청AFP화AFP-L3수평，병계산 AFP-L3재총AFP중소점비례（AFP-L3％）。결과PLC조환자혈청AFP、AFP-L3％수평균고우간경화조화만성간염조（P＜0．05）。이AFP＞25 ng/mL ，AFP-L3％≥10％작위양성판단표준，PLC조환자혈청AFP양성솔고우간경화조화만성간염조，차PLC조환자혈청AFP-L3％양성솔역명현고우간경화조화만성간염조（P＜0．05），단구유불동혈청AFP수평적PLC환자지간，혈청AFP-L3％수평화양성솔비교차이균무통계학의의（P＞0．05）。결론미량리심주법검측혈청AFP-L3％재간암적조기진단화량、악성간병적감별진단중구유중요개치。
Objective To study the clinical significance of serum alpha fetoprotein (AFP) variants (AFP-L3) detected by trace column centrifugation method for the diagnosis of liver cancer and differential diagnosis of benign and malignant liver diseases .Methods During June 2011 and October 2012 ,80 patients with primary liver cancer (PLC ,PLC group) ,66 patients with liver cirrhosis (cirrhosis group) and 54 patients with chronic hepatitis (hepatitis group) treated in this hospital were enrolled .Domestic-made trace column centrifugation kit was used to separate and purify serum AFP-L3 .AFP and AFP-L3 were detected by using chemoluminescence assay .Then ,the percentage of AFP-L3 in AFP (AFP-L3% ) was calculated .Results Levels of serum AFP and AFP-L3% in PLC group were sig-nificantly higher than cirrhosis group and hepatitis group ( P< 0 .05 ) .When taking AFP > 25 ng/mL and AFP-L3% ≥10% as positive judgment standards ,the positive rate of serum AFP in PLC group was higher than cirrhosis and hepatitis group ,and positive rate of AFP-L3% in PLC group was also higher than cirrhosis and hepatitis group (P<0 .05) .In PLC group ,there were no significant difference of AFP-L3% level and its positive rate between pa-tients with different serum levels of AFP (P>0 .05) .Conclusion AFP-L3% ,detected by trace column centrifugation method could be with great significance for the early diagnosis of PLC and the differential diagnosis of benign and malignant liver diseases .