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血清甲胎蛋白(AFP)和甲胎蛋白异质体L3(AFP-L3)在临床上鉴别肝肿块患者的肝细胞癌。

Serum AFP and AFP-L3 in clinically distinguished hepatocellular carcinoma from patients with liver masses.

作者信息

Subwongcharoen Somboon, Leelawat Kawin, Treepongkaruna Sa-ard, Narong Siriluck

机构信息

Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2011 Mar;94 Suppl 2:S46-51.

Abstract

OBJECTIVE

To determine the ability of alpha fetoprotein (AFP) and AFP-L3% serum level in discriminating hepatocellular carcinoma (HCC) from other types of liver mass.

MATERIAL AND METHOD

This study was performed according to a prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) design. A total of 109 HCC patients and 51 patients with other types of liver mass were consecutively selected. The levels of AFP and AFP-L3% in their sera were measured.

RESULTS

AFP levels in serum significantly elevated while AFP-L3% levels significantly decreased in HCC patients (AFP: p < 0.001, AFP-L3%: p < 0.001). The area under the curve (AUC) of a receiver operating characteristic (ROC) curve analysis for the diagnosis of HCC of AFP and AFP-L3% was 0.71 and 0.67, respectively. In addition, the serum level of AFP-L3% was significantly different between the small (mass occupying lesser than 50% of liver volume) and large (mass occupying more than 50% of liver volume) HCC (p = 0.040).

CONCLUSION

The diagnostic accuracy of serum AFP and AFP-L3% could provide them as candidate biomarkers to discriminate patients with HCC from patients with other types of liver mass. Serum AFP-L3% as a prognostic factor for HCC should be further evaluated in more details.

摘要

目的

确定甲胎蛋白(AFP)和AFP-L3%血清水平在鉴别肝细胞癌(HCC)与其他类型肝脏肿物方面的能力。

材料与方法

本研究按照前瞻性样本收集、回顾性盲法评估(PRoBE)设计进行。连续选取了109例HCC患者和51例其他类型肝脏肿物患者。检测了他们血清中的AFP和AFP-L3%水平。

结果

HCC患者血清中的AFP水平显著升高,而AFP-L3%水平显著降低(AFP:p < 0.001,AFP-L3%:p < 0.001)。AFP和AFP-L3%诊断HCC的受试者操作特征(ROC)曲线分析的曲线下面积(AUC)分别为0.71和0.67。此外,小肝癌(肿物占肝脏体积小于50%)和大肝癌(肿物占肝脏体积大于50%)患者血清中的AFP-L3%水平存在显著差异(p = 0.040)。

结论

血清AFP和AFP-L3%的诊断准确性可使其作为鉴别HCC患者与其他类型肝脏肿物患者的候选生物标志物。血清AFP-L3%作为HCC的预后因素应进一步进行更详细的评估。

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