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目的评价α_L_岩藻糖苷酶(AFu)的临床意义。方法应用微量分光光度法检测良、恶性肝病及胃肠道肿瘤327例血清AFu活性。结果AFu以HCC组最高(654.7±204.6μmol·L-1·h-1),明显高于慢性肝炎(415.7±169.4)、肝硬变(412.5±146.8)、肝脏良性占位(390.4±143.1)、胃肠道恶性肿瘤(390.8±178.3)及正常对照(381.9±114.5),P<0.01。对HCC诊断敏感性、特异性与AFP相当,随访1_5年发现13例AFu升高患者6例在6_28月内确诊为HCC,早于AFP阳性4_8周。部分良性肝病AFu升高均与肝功损害呈平行关系。AFu在HCC和胃肠道恶性肿瘤无明显重迭,在疗效分析中AFu与AFP相当,但早于AFP1周时间。结论AFu对HCC特别是对早期AFP阴性HCC的诊断、鉴别、疗效评价及高危人群监测有重要价值
Objective To evaluate the clinical significance of α_L_fucosidase (AFu). Methods The serum AFu activity in 327 cases of benign and malignant liver diseases and gastrointestinal tumors was detected by microspectrophotometry. Results AFu was highest in the HCC group (654.7±204.6 μmol·L-1·h-1), which was significantly higher than that of chronic hepatitis (415.7±169.4) and cirrhosis (412.5±146.8). ), Liver benign (390.4±143.1), Gastrointestinal cancer (390.8±178.3) and normal control (381.9±114.5), P<0.01. The sensitivity and specificity of HCC diagnosis were comparable to those of AFP. In 1 to 5 years of follow-up, 13 patients with elevated AFu were found to have been diagnosed with HCC within 6-28 months, 4-8 weeks earlier than AFP. The increase of AFu in some benign liver diseases is parallel to the damage of liver function. AFu showed no significant overlap in HCC and gastrointestinal malignancy. AFu was comparable to AFP in efficacy analysis, but earlier than AFP for 1 week. Conclusion AFu has important value in the diagnosis, differential diagnosis, curative effect evaluation and high-risk group monitoring of HCC, especially early AFP-negative HCC