Burditt L J, Johnson M M, Johnson P J, Williams R
Institute of Liver Studies, King's College Hospital, School of Medicine and Dentistry, London, United Kingdom.
Cancer. 1994 Jul 1;74(1):25-9. doi: 10.1002/1097-0142(19940701)74:1<25::aid-cncr2820740106>3.0.co;2-u.
Serum alpha-fetoprotein (AFP) is elevated in up to 80% of patients with hepatocellular carcinoma (HCC). Modestly raised AFP levels (10-400 ng/ml) are also found in patients with nonmalignant liver diseases. In the present study, isoelectric focusing of AFP was used to differentiate the AFP found in patients with HCC.
To establish the assay conditions, isoelectric focusing was performed on sera from 14 patients with HCC and 13 with nonmalignant liver diseases. Sera was also analyzed under coded conditions from 16 patients with HCC, 14 with chronic active hepatitis (CAH), and 6 with cirrhosis to determine the specificity and sensitivity of the assay in the diagnosis of HCC.
Isoelectric focusing of sera from patients with HCC and various non malignant liver diseases identified AFP variants (AFP I-IV). All 14 patients with HCC had AFP variants I and III, and 7 of the 14 also had variant IV. When analyzed in the coded study 13 of the 16 cases of HCC were predicted correctly by the presence of AFP variants III or III and IV. AFP bands III and IV were not discernible in 12 of the 14 patients with CAH and 4 of the 6 with cirrhosis.
Isoelectric focusing of sera from patients with HCC and nonmalignant liver disease identified two AFP variants apparently specific for HCC. In the setting of borderline elevation of AFP, this technique has a sensitivity of 81% and specificity of 85% for detecting the presence of bands III or IV and may prove suitable for use in a routine laboratory as a screening assay.
高达80%的肝细胞癌（HCC）患者血清甲胎蛋白（AFP）升高。非恶性肝病患者中也可发现AFP水平轻度升高（10 - 400 ng/ml）。在本研究中，采用AFP等电聚焦法鉴别HCC患者体内的AFP。
为确定检测条件，对14例HCC患者和13例非恶性肝病患者的血清进行等电聚焦分析。还对16例HCC患者、14例慢性活动性肝炎（CAH）患者和6例肝硬化患者的血清进行编码条件分析，以确定该检测方法在HCC诊断中的特异性和敏感性。
HCC患者和各种非恶性肝病患者血清的等电聚焦分析鉴定出AFP变体（AFP I - IV）。所有14例HCC患者均有AFP变体I和III，14例中的7例还有变体IV。在编码研究中，16例HCC病例中有13例通过AFP变体III或III和IV的存在被正确预测。14例CAH患者中的12例以及6例肝硬化患者中的4例未检测到AFP条带III和IV。
HCC患者和非恶性肝病患者血清的等电聚焦分析鉴定出两种显然对HCC具有特异性的AFP变体。在AFP临界升高的情况下，该技术检测条带III或IV的敏感性为81%，特异性为85%，可能适用于常规实验室作为筛查检测方法。
