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Objective@#To explore the diagnostic value of single or combined detection of serum tumor markers alpha-fetoprotein (AFP), α-fetoprotein (AFP)-L3 and abnormal clotting (PIVKA-II) in the primary hepatic carcinoma.@*Methods@#Serum AFP, AFP-L3 and PIVKA-II of 56 cases with primary hepatic carcinoma, 46 cases with cirrhosis, 45 cases with other liver disease and 41 healthy persons (control group) were examined by chemiluminescence method, and the differences in the levels of AFP, AFP-L3 and PIVKA-II in each group were compared.@*Results@#Serum level of AFP, AFP-L3 and PIVKA-II in patients with primary liver cancer was significantly higher than that of the cirrhosis, other liver disease and control groups, and the difference was statistically significant (P < 0.05). The receiver operating characteristic curve analysis showed that the areas under the curve for the diagnosis of primary hepatic carcinoma by AFP, AFP-L3 and PIVKA-II were 0.887, 0.846 and 0.885, respectively. The combined use of the three tumor markers for the diagnosis of primary hepatic carcinoma increased the area under the curve to 0.899. Among the single detection, AFP had the highest sensitivity of 91.07% and PIVKA-II had the highest specificity at 88.63%. In the combined detection, AFP/PIVKA-II combination had the highest sensitivity of 94.64 %, while the AFP + AFP-L3 + PIVKA-II combination had the highest specificity at 98.48%.@*Conclusion@#Combined detection of AFP, AFP-L3 and PIVKA-II could improve the diagnostic specificity and the sensitivity of primary hepatic carcinoma; thereby make up the deficiency of single detection and improve the early diagnosis rate.
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Objective To investigate the clinical value of serum alpha fetoprotein -L3 ( AFP-L3) and Golgi body protein (GP73) in the diagnosis and assessment of primary liver cancer.Methods From October 2013 to May 2017,125 cases with primary liver cancer in Tengzhou Central People's Hospital were selected as hepatocellular carcinoma(HCC) group,and 60 patients with benign liver lesions were selected as benign lesion group ,in the same period,60 healthy people were selected as control group.The separation of AFP -L3 was through microspincolum method,enzyme-linked immunosorbent assay was used to detect GP 73.Results The serum AFP -L3 and GP73 levels in the HCC group were (33.16 ±9.17)%,(309.61 ±10.16) μg/L,respectively,which in the benign lesion group were (4.19 ±1.97)%,(43.18 ±9.17) μg/L,respectively,which in the control group were (3.25 ± 1.26)%,(38.52 ±7.09)μg/L,respectively.The serum levels of AFP-L3 and GP73 in the HCC group were signif-icantly higher than those in benign lesion group and control group (t ＝13.264,9.065,15.328,10.826,all P＜0.05).The serum levels of AFP-L3 and GP73 between the benign lesion group and control group had no statistically significant differences (t＝0.635,0.772,all P＞0.05).The sensitivity,specificity and accuracy of AFP -L3 in the diagnosis of primary liver cancer were 74.2%,87.5%and 91.2%,respectively.The sensitivity,specificity and accu-racy of GP73 in the diagnosis of primary liver cancer were 84.7%,81.4%and 92.4%,respectively.The sensitivity, specificity and accuracy of combined detection of them in diagnosis of primary liver cancer were 98.2%,89.6%and 97.1%,respectively.The sensitivity and accuracy of the combined tests were significantly higher than AFP -L3 or GP73 alone (t＝5.026,4.114,3.018,2.776,all P＜0.05).According to TNM staging,125 patients with HCC were divided into stage Ⅰ+Ⅱ and Ⅲ+Ⅳ.The serum AFP -L3 and GP73 levels in patients with stage Ⅰ+Ⅱ were (28.25 ±8.26)%,(202.86 ±9.24) μg/L,respectively,which were significantly lower than those in patients with stage Ⅲ+Ⅳ[(43.17 ±10.24)%,(398.62 ±11.35)μg/L] (t ＝3.772,3.182,all P ＜0.05).Conclusion The serum levels of AFP -L3 and GP73 in patients with primary liver cancer are obviously higher.Combined detection can improve the sensitivity and accuracy of diagnosis ,and the degree of increase is related to the severity of the patients.
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Serological markers have the features of noninvasiveness and simple operation and thus have become a research hotspot in the diagnosis of hepatocellular carcinoma.This article briefly introduces the role of the conventional serological marker alpha-fetoprotein (AFP) in assisting the diagnosis and predicting the prognosis of HBV-related liver cancer, as well as the clinical value of new markers such as alpha-fetoprotein-L3 and abnormal prothrombin/des-γ-carboxy prothrombin.Based on literature review, the possibility of serum Golgi protein 73 used for laboratory auxiliary diagnosis of hepatocellular carcinoma has been denied.The results of the author′s experiment suggest that serum GP73 measurement can be used as a laboratory diagnostic index for progressive liver fibrosis and liver cirrhosis.
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Objective To identify the changes of serum alpha-fetoprotein (AFP) and AFP-L3 levels after surgical resection of hepatocellular carcinoma (HCC), so as to evaluate the role of AFP-L3 in predicting post-operative HCC recurrence. Methods A total of 67 HCC patients who received surgical resection from Jan. 2007 to Dec. 2007 were enrolled in the present study. The detailed clinical data were obtained for each patient. Pre- and post-operative serum AFP and AFP-L3 levels were measured continuously, and patterns of their post-operative changes were followed up for a long-term period. Results The overall 1-, 2- and 3-year recurrence rates of the patients were 23. 9% (16/67), 38. 8% (26/67) and 50. 7% (34/67), respectively. There was no relationship between serum AFP and AFP-L3 level before operation Os = 0. 176, P = 0. 155). The pre-operation serum AFP-L3 level was significantly correlated with tumor recurrence (rs = 0. 327, P = 0. 007), but the relation between pre-operation serum AFP level and tumor recurrence was not clear yet(rs = 0. 240, P = 0. 051). Conclusion Serum AFP-L3 level is associated with HCC recurrence and therefore valuable for predicting HCC recurrence; it can provide clinicians with more information for judging the therapeutic efficacy of HCC patients.
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Objective To explore the prognostic value of the content of lentil lectin-reactive alphafetoprotein-L3(AFP-L3)in early-stage hepatocellular carcinoma(HCC).Methods According to the content of alpha.fetoprotein(AFP)and AFP-L3 before the treatment,97 patients with early-stage HCC were divided into group A(AFP＞20 μg/L & AFP-L3＜15%,n=29),group B(15%≤AFP-13≤50% & 20 μg/L≤AFP≤200 μg/L,n=16),group C(AFP-13＞50%& AFP＞200 μg/L,n=13),group D(AFP-L3＞50% & 20 μg/L≤AFP≤200 μg/L,n=24)and group E(15%≤AFP-L3≤50%& AFP＞200 μg/L,n=15).The degree of tumor differentiation,the 1-,2-,3-year survival rates and tumor-free survival rates of the patients were analyzed.Results The degree of tumor differentiation.3-year survival rate and tumor-free survival rate of patients in group A were significantly higher than those in the other 4 groups(χ2=21.051,10.043,4.450,6.977,25.566,P＜0.05).The degree of tumor differentiation,1-,2-,3-year survival rates and tumor-free survival rates of the patients in group C and D were significantly lower than those in other 3 groups(χ2=7.938,3.488,9.085.P＜0.05).Conclusions The increase of AFP-L3 content is closely related to poorly differentiated HCC and bad prognosis.especially when the AFP Ievel is low.The detection of AFP-L3 content before and after operation is beneficial to the evaluation of the prognosis of HCC patients.