关键词: 原发性肝癌, 肝硬化, 慢性乙型肝炎, 腺苷脱氨酶, α-L-岩藻糖苷酶, 甲胎蛋白-L3, 诊断

Abstract: Objective The aim of this study was to investigate the implications of serum adenosine deaminase (ADA), α-L-fucosidase (AFU) and alpha fetoprotein-L3 levels in patients with chronic hepatitis B (CHB), liver cirrhosis (LC) and primary liver cancer (PLC). Methods 76 patients with CHB, 31 patients with LC and 29 patients with hepatitis B-associated PLC were encountered in our hospital between January 2020 and April 2022, and serum ADA level was detected by enzymatic colorimetry. Serum AFU level was assayed by special kits and serum AFP-L3 level was determined by enzyme linked immunosorbent assay. The liver biopsies were performed in all patients with CHB. The diagnostic performance was evaluated by the area under the receiver operating characteristic curve (AUC). Results Based on the liver histopathologic examination in patients with CHB, the G0, G1, G2, G3 and G4 were found in (12 cases, 18 cases, 26 cases, 16 cases and 4 cases, and the S0, S1, S2, S3 and S4 were found in 14 cases, 7 cases, 14 cases, 20 cases and 21 cases; serum ADA, AFU and AFP-L3 levels in 46 patients with G2-G4 CHB were (29.6±5.1)μ/L, (34.7±5.0)μ/L and (6.9±1.2)%, all significantly higher than [(25.4±3.9)μ/L, (29.5±5.2)μ/L and (5.8±0.8)%, respectively, P<0.05] in 30 patients with G0/G1 CHB, and serum ADA, AFU and AFP-L3 levels in 55 patients with S2-S4 CHB were (43.8±10.1)μ/L, (66.5±18.8)μ/L and (8.3±1.3)%, significantly higher than (28.1±6.0)μ/L, (33.0±8.4)μ/L and (6.4±1.1)%, P<0.05] in 21 patients with S0/S1 CHB; serum ADA, AFU and AFP-L3 levels in patients with PLC were(51.3±5.2)μ/L, (82.0±9.5)μ/L and (9.2±1.3)%, significantly higher than [(38.1±4.6)μ/L, (51.8±5.1)μ/L and (7.8±1.1)%, respectively, P<0.05] in patients with LC or [(26.5±4.6)μ/L, (30.9±5.6)μ/L and (6.1±0.8)%, respectively, P<0.05] in patients with CHB; the AUCs determined by serum AFP-L3 level were 0.857, with the sensitivity (Se) of 86.2% and the specificity of 88.8%, much superior to that by AFU(0.752, 79.3% and 77.6%, respectively) or that by ADA(0.722, 75.8% and 76.6%, respectively, P<0.05), when serum AFP-L3=7.9%, serum AFU=55.1μ/L and serum ADA=46.0μ/L were set as the cut-off-value for predicting the existence of PLC. Conclusion The diagnostic performance of serum AFP-L3 levels in predicting PLC is superior to that of serum ADA or AFU levels, which might under the circumstance of imaging help the clinicians making an appropriate decisions.

Key words: Hepatoma, Hepatitis B, Liver cirrhosis, Alpha fetoprotein-L3, Adenosine deaminase, α-L-fucosidase, Diagnosis