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中华普通外科学文献(电子版) ›› 2010, Vol. 04 ›› Issue (04) : 311 -314. doi: 10.3877/cma.j.issn.1674-0793.2010.04.005

所属专题: 文献

论著

甲胎蛋白异质体3、异常凝血酶原、甲胎蛋白检测肝细胞癌的对照研究
邝妙欢1,(), 欧阳文婷2, 林建华1, 吴兴平1   
  1. 1. 510060 广州,华南肿瘤学国家重点实验室,中山大学肿瘤防治中心检验科
    2. 中山大学附属第一医院检验科
  • 收稿日期:2010-03-25 出版日期:2010-08-01
  • 通信作者: 邝妙欢

Clinical evaluation of three tumor markers in hepatocellular carcinoma diagnosis: alpha-fetoprotein-L3, des-gamma-carboxy prothrombin and alpha-fetoprotein

Miao-huan KUANG1,(), Wen-ting OU YANG2, Jian-hua LIN1, Xing-ping WU1   

  1. 1. State Key Laboratory of Oncology in South China; Department of Laboratory Medicine of Cancer Center, SUN Yat-sen University, Guangzhou 510060, China
  • Received:2010-03-25 Published:2010-08-01
  • Corresponding author: Miao-huan KUANG
  • About author:
    Corresponding author: KUANG Miao-huan, Email:
引用本文:

邝妙欢, 欧阳文婷, 林建华, 吴兴平. 甲胎蛋白异质体3、异常凝血酶原、甲胎蛋白检测肝细胞癌的对照研究[J/OL]. 中华普通外科学文献(电子版), 2010, 04(04): 311-314.

Miao-huan KUANG, Wen-ting OU YANG, Jian-hua LIN, Xing-ping WU. Clinical evaluation of three tumor markers in hepatocellular carcinoma diagnosis: alpha-fetoprotein-L3, des-gamma-carboxy prothrombin and alpha-fetoprotein[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(04): 311-314.

目的

分析3种肿瘤标志物甲胎蛋白异质体(AFP-L3)、异常凝血酶原(DCP)、甲胎蛋白(AFP)单独或联合检测肝细胞癌(HCC)的临床意义。

方法

分别用电化学发光法检测AFP,ELISA法检测AFP-L3、DCP,利用受试者工作特征曲线(ROC曲线)分析3种标志物单独和联合检测肝细胞癌(随机组和AFP阴性组)的敏感性、特异性、曲线下面积、阳性预测值和阴性预测值。比较肝细胞癌组与健康对照组和疾病对照组的AFP-L3、DCP、AFP水平的差异。分析治疗前AFP阴性肝细胞癌病例联合检测AFP-L3、DCP的意义。

结果

①单独检测肝细胞癌病例的3种肿瘤标志物,AFP-L3的敏感性、特异性分别是48.7%、97.7%;DCP的敏感性、特异性分别是42.5%、98.4%;AFP的敏感性、特异性分别是68.7%、94.6%。联合检测AFP-L3、DCP和AFP,敏感性、特异性分别是87.5%、92.2%。②肝细胞癌随机组的AFP-L3、DCP、AFP水平与健康对照组和疾病组比较差异有高度统计学意义(P<0.01)。③AFP阴性肝细胞癌组的AFP和AFP-L3水平与肝良性疾病组比较差异无统计学意义,但DCP水平差异有统计学意义(P<0.05)。

结论

AFP-L3、DCP与AFP单独检测时AFP的敏感性最高,而DCP的特异性最高,是区分肝硬化与AFP阴性的肝细胞癌血清学的良好指标。AFP-L3、DCP与AFP的联合检测能提高肝细胞癌血清学检测的敏感性和特异性,在肝细胞癌诊断方面比目前大多数传统的组合方法更优胜、更准确。

Objective

To determine values of detecting alpha-fetoprotein-L3(AFP-L3), des-gamma-carboxy prothrombin(DCP) and alpha-fetoprotein(AFP) alone or in combination for diagnosis of hepatocellular carcinoma(HCC).

Methods

Serum samples from 259 patients, including 130 HCC cases without treatment and 129 cases as controls, were detected for AFP by ECLIA, DCP and AFP-L3 by ELISA respectively. They were also analyzed by Receiver operating characteristic (ROC).

Results

The sensitivity of AFP-L3, DCP, and AFP was 48.7%, 42.5%, 68.7%, respectively. And the specificity was 97.7%, 98.4%, 92.2%, respectively. Value of the three markers between the HCC group and the control group showed significantly different when compared separately (P<0.05). While those in combination, the sensitivity, specificity were 87.5%, 92.2%. There were 79 HCC patients whose AFP were negative the DCP value of them showed significant differences(P<0.05), while AFP-L3 showed no differences.

Conclusions

Among the three markers,AFP is the most sensitive, and DCP is the highest specific. DCP may be the better marker for those AFP-negative patients of HCC. The combination of AFP-L3, DCP and AFP can elevate the sensitivity and have a highly specificity,which is superior for diagnosis of HCC compared with each marker alone or to other combinations.

表1 各组的血清肿瘤标志物浓度水平和阳性率(%)
表2 3种肿瘤标志物检测治疗前肝细胞癌病例的ROC曲线分析情况表
图1 HCC随机组的ROC曲线图
图2 AFP阴性的HCC的ROC曲线图
1
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Zinkin NT, Grall F, Bhaskar K, et al. Serum proteomics and biomarkers in hepatocellular carcinoma and chronic liver disease. Clin Cancer Res, 2008, 14(2):470-477.
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