血清甲胎蛋白、甲胎蛋白异质体、磷脂酰肌醇蛋白聚糖-3联合诊断肝细胞肝癌的临床价值

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摘要目的研究血清甲胎蛋白（AFP）、甲胎蛋白异质体（AFP-L3）、磷脂酰肌醇蛋白聚糖-3（GPC3）联合诊断肝细胞肝癌（HCC）的临床价值。方法选取2018年4月至2021年3月广州市花都区人民医院诊断的136 例疑似HCC患者纳入HCC 组，129 例肝脏良性疾病患者纳入良性组，选取同期广州市花都区人民医院诊治的140 例肝炎肝硬化患者纳入对照组。检测并比较三组患者的血清AFP、AFP-L3、GPC3 水平，以术后肝组织病理活检为金标准，评价AFP、AFP-L3、GPC3 单独、联合诊断HCC 的价值。结果 HCC 组患者的血清AFP、AFP-L3、GPC3 水平均高于良性组、对照组，良性组患者的血清AFP、AFP-L3、GPC3 水平均高于对照组，差异有统计学意义（P＜0.05）。AFP、AFP-L3、GPC3 联合诊断HCC 的灵敏度、特异度、阴性预测值、阳性预测值、准确度均高于AFP、AFP-L3、GPC3 单独及两两联合诊断。结论血清AFP、AFP-L3、GPC3 与HCC 关系密切，检测其水平有助于HCC 的临床诊断，三者联合检测可显著提高HCC 诊断率。

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关键词 ：甲胎蛋白, 甲胎蛋白异质体, 铁蛋白, 肝细胞肝癌

Abstract：Objective To study the clinical value of serum alpha-fetoprotein (AFP), alpha-fetoprotein-L3 (AFP-L3)and glypican-3 (GPC3) in the combined diagnosis of hepatocellular carcinoma (HCC). Methods A total of 136 Patients with suspected HCC diagnosis in the People′s Hospital of Huadu District, Guangzhou City from April 2018 to March 2021 were selected as the HCC group, 129 patients with benign liver diseases were selected as the benign group, and 140 patients with hepatitis and cirrhosis treated in the People′s Hospital of Huadu District, Guangzhou City during the same period were selected as the control group. The serum levels of AFP, AFP-L3, and GPC3 in the three groups were detected and compared. Postoperative liver biopsy was used as the gold standard to evaluate the value of AFP, AFPL3, and GPC3 for the diagnosis of HCC alone or in combination. Results The levels of AFP, AFP-L3, and GPC3 in the HCC group were higher than those in the benign group and the control group, and the levels of AFP, AFP-L3 and GPC3 in the benign group were higher than those in the control group,and the differences were statistically significant(P<0.05).The sensitivity, specificity, negative predictive value, positive predictive value and accuracy of AFP, AFP-L3, and GPC3 combined diagnosis for HCC were higher than AFP, AFP-L3, and GPC3 alone or in combination. Conclusion Serum AFP, AFP-L3, and GPC3 are closely related to HCC. Detection of their levels is helpful for the clinical diagnosis of HCC, and combined detection of the three can significantly improve the diagnosis rate of HCC.

Key words： Alpha-fetoprotein Alpha-fetoprotein-L3;Ferritin Hepatocellular carcinoma

基金资助:广东省广州市科技计划项目（202002030044）；广东省广州市花都区人民医院院内科研基金项目（2020B03）。

通讯作者: 赵娟（1984-），女，湖南祁阳人，硕士，副主任技师，研究方向：产前诊断、优生优育、遗传、感染性疾病、肿瘤遗传等。

作者简介: 李辉（1981-），男，湖南郴州人，硕士，副主任医师，研究方向：内科疾病、感染性疾病、肝、肺病等。

引用本文:

李辉；赵娟；徐沛演；张成芳；谭丽娟；刘美三. 血清甲胎蛋白、甲胎蛋白异质体、磷脂酰肌醇蛋白聚糖-3联合诊断肝细胞肝癌的临床价值[J]. 中国当代医药, 2022, 29(9): 66-69.
LI Hui；ZHAO Juan；XU Peiyan；ZHANG Chengfang；TAN Lijuan；LIU Meisan. Clinical value of combination of serum alpha-fetoprotein, alpha-fetoprotein heterosomes and phosphatidylinositol proteoglycan 3 in the diagnosis of hepatocellular carcinoma. 中国当代医药, 2022, 29(9): 66-69.

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