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目的观察原发性肝癌高危人群慢性乙型肝炎及乙型肝炎肝硬化代偿期患者血清标志物甲胎蛋白(AFP)、甲胎蛋白异质体3(AFP-L3)、高尔基体蛋白73(GP73)的浓度,提高原发性肝癌早期诊断率。方法对30例慢性乙型肝炎患者(肝炎组)和30例乙型肝炎肝硬化(肝硬化组)代偿期患者,定量检测血清标志物AFP、AFP-L3、GP73的浓度。并在48周后复查。结果肝炎组血清AFP、AFP-L3、GP73浓度低于肝硬化组,差异有统计学意义(P<0.05);24周后肝硬化组3例AFP正常,而AFP-L3、GP73浓度升高的患者肝脏磁共振检查确诊为原发性肝癌。48周后肝硬化组又有2例AFP-L3、GP73浓度升高的患者肝脏磁共振检查确诊为原发性肝癌。结论临床上慢性乙型肝炎及肝硬化代偿期均可能进展为肝癌,但肝硬化患者更容易进展为肝癌,检测血清标志物AFP、AFP-L3、GP73浓度可提高早期原发性肝癌诊断的准确性。
Objective To observe the serum levels of AFP, AFP-L3 and Golgi protein 73 (AFP-L3) in chronic hepatitis B and decompensated patients with hepatitis B cirrhosis GP73) concentration, improve the early diagnosis of primary liver cancer. Methods Thirty patients with chronic hepatitis B (hepatitis group) and 30 patients with decompensated hepatitis B cirrhosis (cirrhosis) were enrolled in this study. Serum levels of AFP, AFP-L3 and GP73 were measured quantitatively. And in 48 weeks after the review. Results The levels of serum AFP, AFP-L3 and GP73 in hepatitis group were lower than those in cirrhosis group (P <0.05). After 24 weeks, the AFP-L3 and GP73 levels were normal in 3 cases of cirrhosis group Patients with liver magnetic resonance imaging diagnosed with primary liver cancer. After 48 weeks, another two patients with liver cirrhosis AFP-L3, GP73 concentrations in patients with liver magnetic resonance imaging diagnosed as primary liver cancer. Conclusions Both clinical diagnosis of chronic hepatitis B and decompensation of liver cirrhosis may progress to liver cancer. However, patients with cirrhosis are more likely to develop liver cancer. Serum markers AFP, AFP-L3 and GP73 concentrations may improve the diagnosis of early-stage primary liver cancer accuracy.