【摘要】 目的探讨3种血清肿瘤标志物a-L岩藻糖苷酶(α-L-fucosidase,AFU)、AFP异质体(6alpha-fetoprotein variant,AFP-L3)及同型半胱氨酸(Hyperhomocysteinemia,Hcy)联合检测原发性肝癌(primary hepatic cancer,PHC)的早期诊断价值及临床界值。方法对我院2004年11月-2005年12月收治的640例肝病患者,其中经手术和病理诊断确诊为PHC者84例,非PHC者556例。对640例肝病患者的血清联合检测AFU、AFP-L3及HCY。采用速率法测定AFU水平,电泳亲和印迹法测定AFP-L3,采用IMx同型半胱氨酸专用试剂包测定HCY。结果PHC组血清AFU、AFP-L3及HCY水平分别为(40±18.5)U/L、(30±16.4)%、(18.9±9.7)μmol/L;非PHC患者血清AFU、AFP-L3及HCY水平分别为(16.4±9.8)U/L、(15.2±4.2)%、(9.4±4.9)μmol/L,二者相比有统计学意义(P<0.01);PHC组AFU、AFP-L3及HCY在ROC曲线下的面积(AUC)分别0.464、0.854、0.881,而三者联合检测的AUC为0.936。经ROC曲线分析,AFU40 U/L、AFP-L330%、HCY18.9μmol/L联合应用的临界值,敏感度和特异度均可达85%,阳性似然比为5.12,阴性似然比为0.17。结论联合检测AFU、AFP-L3及HCY3项指标对HPC的早期诊断有一定的指导意义。更多还原

【Abstract】 Objective To study the complementary value and cut off of α-L-fucosidase(AF),alpha-fetoprotein variant(AFP-L3)and Hyperhomocysteinemia(HCY)in the earlyu diagnosis of primary hepatic cancer.Methods Serum AFU、AFP-L3 adn HCY were measured in 84 cases with primary hepatic cancer and 30 cases with hepatitis B and 30 normal cases admitted in our hospital from November 2004 to December 2005.The level of AFU were deteted by speed method,AFP-L3 were detected by affinity eletrophoresis blotting test,and Hcy were detected by special-purpose reagent package of IMx homocystieine.Results The level of serum AFU、AFP-L3 and HCY have significant statistical difference between the PHC group and normal group(P<0.01).The diagnostic sensitivities of AFU、AFP-L3 and HCY to primary hepatic cancer were 46.43%、84.52%、88.10%,combines detection of these three indices could make the diagnostic sensitivity as high as 93.63%;The result of Hcy between PHC group and coronary heart disease group have sinificant(P<0.05).Conclusion The combined of AFU、AFP-L3 and HCY have a guiding value in the early diagnosis of primary hepatic cancer.更多还原