Sun Gui-zhen, Zhao Xiu-ying, Li Jun-hong, Zhao Guo-qing, Wang Shao-xiang, Kong Shu-ling
Center of Clinical Laboratories, Beijing You' an Hospital, Capital Medical University, Beijing 100069, China.
Zhonghua Yi Xue Za Zhi. 2008 Jul 22;88(28):1986-8.
To explore the effect of use of lens culinaris agglutinin (LCA)-coupled spin column (ACSC) in detection of alpha-fetoprotein (AFP) isoform AFP-L3 and to evaluate the value of AFP-L3 as a biomarker in diagnosis of hepatocellular-carcinoma (HCC).
The serum samples of 132 patients with elevated AFP level (20-1000 microg/L), 79 diagnosed as with HCC and 53 with benign liver diseases (35 with liver cirrhosis and 18 with chronic hepatitis) underwent ACSC to isolate the fraction of AFP-L3. The contents of AFP and AFP-L3 were detected by micro-particle immunoassay. The ratio of AFP-L3 to total AFP, AFP-L3%, was calculated. Correlation between the abnormally elevated AFP-L3% and HCC was analyzed.
Detection of AFP-L3% using ACSC method was operating friendly. The average value of AFP-L3% in the patients with HCC was 36.4%, significantly higher than those of the patients with benign liver diseases (5.3% respectively, P < 0.01). The area under the receiver operating characteristic (ROC) curve of AFP-L3% was 0.807. Taking AFP-L3% > or = 10% as diagnostic criteria, the sensitivity of AFP-L3% in HCC diagnosis was 84.8% (67/79) and the specificity was 92.5% (49/53), with a total conformity rate of 87.9% compared to the confirmed clinical diagnosis. Conclusion ACSC is of clinical value in detecting AFP-L3. AFP-L3% is a valuable biomarker in diagnosis and prediction of prognosis of HCC.
探讨使用刀豆球蛋白A（LCA）偶联自旋柱（ACSC）检测甲胎蛋白（AFP）异构体AFP-L3的效果，并评估AFP-L3作为生物标志物在肝细胞癌（HCC）诊断中的价值。
对132例AFP水平升高（20 - 1000μg/L）的患者血清样本进行检测，其中79例诊断为HCC，53例患有良性肝病（35例肝硬化，18例慢性肝炎）。采用ACSC分离AFP-L3组分，通过微粒子免疫测定法检测AFP和AFP-L3的含量，计算AFP-L3与总AFP的比值AFP-L3%，分析AFP-L3%异常升高与HCC的相关性。
采用ACSC法检测AFP-L3%操作简便。HCC患者AFP-L3%的平均值为36.4%，显著高于良性肝病患者（分别为5.3%，P < 0.01）。AFP-L3%的受试者工作特征（ROC）曲线下面积为0.807。以AFP-L3%≥10%为诊断标准，AFP-L3%诊断HCC的灵敏度为84.8%（67/79），特异度为92.5%（49/53），与临床确诊诊断的总符合率为87.9%。结论ACSC在检测AFP-L3方面具有临床价值。AFP-L3%是HCC诊断及预后预测的有价值生物标志物。
