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目的探讨血清中脱γ-羧基凝血酶原(DCP)和甲胎蛋白异质体(AFP-L3)对低浓度AFP原发性肝细胞癌(PHC)的应用价值。方法采收集51例低浓度AFP PHC患者、52例非肝癌患者和101例健康对照者的血清分别检测DCP和AFP-L3,并对其统计分析。结果低浓度AFP PHC患者的DCP和AFP-L3阳性率显著高于非肝癌和健康对照者(P<0.05),而非肝癌组和健康对照组两者差异无统计学意义(P>0.05)。DCP和AFP-L3诊断低浓度AFP PHC的灵敏度分别为76.47%(39/51)和70.59%(36/51),特异性分别为96.08%(147/153)和94.12%(144/153)。两项串联检测时,其诊断的特异性略微提高至98.69%(151/153),并联检测时敏感度显著提高至90.20%(46/51)。结论DCP和AFP-L3对低浓度AFP PHC患者具有较强的诊断效能,两项并联检测能有效避免一些漏检病例。
Objective To investigate the value of deproteinizing γ-carboxyl prothrombin (DCP) and alpha-fetoprotein (AFP-L3) in serum of AFP primary hepatocellular carcinoma (PHC). Methods Serum samples from 51 AFP PHC patients, 52 non-HCC patients and 101 healthy controls were collected for the detection of DCP and AFP-L3, and statistical analysis was performed. Results The positive rate of DCP and AFP-L3 in patients with AFP PHC was significantly higher than that in non-HCC and healthy controls (P <0.05), but not in HCC patients and healthy controls (P> 0.05). The sensitivity of DCP and AFP-L3 for diagnosing low-concentration AFP PHC was 76.47% (39/51) and 70.59% (36/51), respectively, with specificity of 96.08% (147/153) and 94.12% (144/153), respectively. The diagnostic specificity increased slightly to 98.69% (151/153) for two series tests and significantly increased to 90.20% (46/51) for parallel tests. Conclusions DCP and AFP-L3 have strong diagnostic efficacy in patients with low-concentration AFP PHC. Two parallel tests can effectively avoid some missed cases.