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甲胎蛋白(AFP)升高是诊断原发性肝癌(PHC)的重要血清标志物,但仍有30％左右患者的AFP呈阴性或低浓度,不易作出诊断。重庆医科大学附二院沈鼎明教授等根据国际最新动态,研究了α-L-岩藻糖苷酶(AFU)对PHC诊断的意义,并结合r-谷氨酰转肽酶Ⅱ(r-GTⅡ)、碱性磷酸酶Ⅰ(ALPⅠ)、醛缩酶同功酶A(ALDA),组成四种酶标志物进行同步联合检测。研究结果表明,59例PHC组的AFU值为14.48±5.73u,显著高于正常值3.33±0.72u,并高于重型、急性、慢性肝炎、转移性肝癌、肝硬化、肝良性占位性病变及其它消化道癌肿对照组;对PHC的诊断敏感性达78.8％,特异性达90.9％;对AFP阴性的PHC诊断阳性率达81.8％,尤其是2例AFP阴性的亚临床肝癌的AFU值为阳性(≥10.5u),提示AFU可能具有早期诊断PHC的意义;其四种标志物联合诊断AFP阴性或低浓度的PHC病例,检出率达87.5％;如四种标志物与AFP联合检测,则对PHC的诊断阳性率达到93.9％。
Alpha-fetoprotein (AFP) elevation is an important serum marker for the diagnosis of primary liver cancer (PHC), but there are still 30% of patients with AFP negative or low concentrations, making it difficult to make a diagnosis. Professor Shen Dingming of the Second Affiliated Hospital of Chongqing Medical University, etc. studied the significance of α-L-fucosidase (AFU) in the diagnosis of PHC according to the latest international trends, and combined with r-glutamyl transpeptidase II (r-GTII), Alkaline phosphatase I (ALPI), aldolase isoenzyme A (ALDA), composed of four enzyme markers for simultaneous detection. The results showed that the AFU value of the 59 PHC group was 14.48±5.73u, which was significantly higher than the normal value of 3.33±0.72u, and was higher than that of severe, acute, chronic hepatitis, metastatic liver cancer, liver cirrhosis, and benign liver lesions. And other gastrointestinal cancer control groups; the diagnostic sensitivity of PHC was 78.8% and specificity was 90.9%; the positive rate of AFP negative PHC diagnosis was 81.8%, especially the AFU value of 2 subclinical liver cancer patients with AFP negative Positive (≥10.5u), suggesting that AFU may have the significance of early diagnosis of PHC; its four markers combined diagnosis of AFP-negative or low concentrations of PHC cases, the detection rate of 87.5%; such as the combination of four markers and AFP The positive rate of diagnosis of PHC reached 93.9%.