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目的通过测定血清中甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体蛋白73(GP73)和α-L-岩藻糖苷酶(AFU)的水平,比较它们在不同肝脏疾病中的意义,原发性肝癌(PHC)患者中不同水平AFP值与AFP-L3、GP73和AFU三者异常率的相关性。方法将734例肝病患者分为PHC组(A组)271例;慢性肝炎组(B组)254例;肝硬化组(C组)209例,另选208例健康体检者(D组),测定血清中的GP73、AFP-L3、AFP和AFU水平。结果三组患者的GP73、AFP-L3和AFP水平及异常率较D组增高(P<0.05);A组和B组的GP73水平及异常率较C组低(P<0.05);B组和C组AFP-L3和AFP水平及异常率低于A组(P<0.05);在A组中,AFP-L3的异常率与AFP呈正相关(r=0.81),AFU的异常率与AFP呈正相关(r=0.83),但GP73的异常率与AFP无明显相关性。结论 GP73更适用于肝硬化鉴别诊断;AFP-L3在诊断PHC中有较高的价值;当AFP值>100ng/ml时,AFP-L3异常率维持在较高水平。
Objective To compare the levels of alpha-fetoprotein (AFP), alpha-fetoprotein heterogeneity (AFP-L3), Golgi protein 73 (GP73) and α-L-fucosidase (AFU) in the serum and compare them. The significance of liver disease, the relationship between AFP values at different levels and abnormal rates of AFP-L3, GP73, and AFU in patients with primary liver cancer (PHC). Methods A total of 734 cases of liver diseases were divided into PHC group (A group) 271 cases; chronic hepatitis group (B group) 254 cases; cirrhosis group (C group) 209 cases, and another 208 healthy physical examination group (D group). Serum levels of GP73, AFP-L3, AFP and AFU. Results The levels of GP73, AFP-L3, and AFP in the three groups were significantly higher than those in group D (P<0.05). The GP73 levels and abnormal rates in group A and B were lower than those in group C (P<0.05). The level and abnormal rate of AFP-L3 and AFP in group C were lower than that in group A (P<0.05). In group A, the abnormal rate of AFP-L3 was positively correlated with AFP (r=0.81). The abnormal rate of AFU was positively correlated with AFP. (r = 0.83), but there was no significant correlation between the abnormal rate of GP73 and AFP. Conclusion GP73 is more suitable for the differential diagnosis of liver cirrhosis; AFP-L3 is of higher value in the diagnosis of PHC; when the AFP value is >100 ng/ml, the abnormal rate of AFP-L3 is maintained at a high level.