关键词: 原发性肝癌, 甲胎蛋白, 甲胎蛋白异质体, 诊断

Abstract: Objective To retrospectively analyze serum alpha-fetoprotein（AFP） and lentil lectin-reactive alpha-fetoprotein ratio（AFP-L3%） in the diagnosis of patients with primary liver cancer （PLC）. Methods A cohort of 7097 patients with PLC was recruited in Eastern Hepatobiliary Surgery Hospital between January 2015 and December 2015. At the same period，122 patients with liver cirrhosis（LC） were enrolled. Serum AFP and AFP-L3 were detected by electrochemiluminescence and lectin microcentrifugalcolunm，respectively. The positivity of AFP-L3 was defined as the ratio of AFP to L3/AFP was higher than 10%. Results Serum AFP level in 7097 patients with PLC was 61.7（5.4，1226.0） μg/L，much higher than 3.6（2.5，10.95） μg/L（P<0.05） in 122 patients with LC，and the AFP-L3 positivity was 8.2（-，26.1）%，significantly higher than in patients with LC as all were negative in the latter（P<0.05）；the accuracy in diagnosis of PLC was 63.1%，higher than 60.3% by serum AFP or 47.9% by AFP-L3 alone when either of serum AFP≥20μg/L and/or AFP-L3≥10% as the cut-off-value； the positivity of AFP-L3 increased as serum AFP levels increased；the positivity of AFP-L3 in PLC patients with negative serum AFP and in LC patients with positive serum AFP were 39.6% and 7.7%，respectively，both significantly lower than 73.7%（P<0.05） in PLC patients with positive AFP；serum AFP levels and positivities of AFP-L3 were 50.8（4.8，1015.0） μg/L and 5.3（-，24.6）% in 1976 patients with histology-proven hepatocellular carcinoma（HCC），and 74.9（4.55，39248.3）μg/L and 8.4（-，18.8）% in 6 patients with histology-proven mixed hepatoma，both higher than 【2.8（2.2，5.15）μg/L，P<0.05】 and 【-（-，-）%，P<0.05】 in 121 patients with histologically diagnosed intrahepatic cholangiocarcinoma. Conclusion Our big data confirm again AFP and AFP-L3 have a higher positive rate in PLC，and its diagnostic value is good.

Key words: Hepatoma, Alpha-fetoprotein, Lentil lectin-reactive alpha-fetoprotein, Diagnosis