肝细胞癌患者血清中循环无细胞DNA、甲胎蛋白及a-L-岩藻糖苷酶联合检测的意义

摘要

目的：探讨循环无细胞 DNA（cfDNA）在肝细胞癌（HCC）中检测的价值及其与甲胎蛋白（AFP）、a-L-岩藻糖苷酶（AFU）联合检测的临床诊断价值。方法收集39例 HCC 患者血清以及45例正常对照血清，采用分支 DNA（branched DNA，bDNA）技术检测血清中 cfDNA 的浓度，同时采用化学发光法检测血清中 AFP 的浓度，比色法测定血清 AFU 的活性，并讨论这三种生物标志物联合检测的意义。结果39例 HCC 患者血清中有22例 cfDNA 含量增高，45例正常对照血清中有2例 cfDNA 含量增高，HCC 患者血清 cfDNA 阳性表达率均显著高于正常对照者（P ＜0．05）；cfDNA 与 AFP、AFU 的一项或者两项联合检测敏感性分别为71．8％、87．2％、89．7％，明显高于单独一项检测敏感性分别为56．4％、53．8％、66．7％，差异有统计学意义（P ＜0．05）。经相关性分析，cfDNA、AFP 与 AFU 这三种生物标志物均无相关性。结论定量分析 cfDNA 的方法用于 HCC 的检测是一种敏感、有效的方法，与 AFP、AFU 联合检测可以大大提高 HCC 的临床诊断。%Objective To investigate the value of circulating free cell DNA (cfDNA)for the diagnosis of hepatocellular carcinoma (HCC),and to explore the value of combined detection of cfDNA,AFP and AFU for the clinical diagnosis.Methods Serum samples from 39 HCC patients and 45 normal controls were collected.Branched DNA(bDNA)was used to detect the level of cfDNA,while AFP (a-fetoprotein)and AFU (a-L-fucosidase)were detected by chemiluminescence and colorimetry respectively.The significance of com-bined detection of the three biomarkers was discussed.Results cfDNA level was increased in 22 of the 39 HCC samples and 2 of the 45 normal controls.cfDNA level in HCC samples was significantly higher than that in normal controls (P <0.05).The sensitivities of combined detection with one item(cfDNA and AFP,cfDNA and AFU),and with two items(cfDNA ,AFP and AFU)were 71.8%, 87.2% and 89.7% versus 56.4%,53.8% and 66.7% for cfDNA and AFP,AFU alone respectively,the difference being statistically significant(P <0.05).By the correlation analysis,there was no significant correlation between cfDNA,AFP and AFU in the detection of HCC.Conclusions Quantitative analysis of cfDNA is sensitive and feasible,and combined detection of cfDNA with AFP or AFU or both can improve the diagnostic sensitivity for HCC.