摘要
目的评价α＿Ｌ＿岩藻糖苷酶（ＡＦｕ）的临床意义。方法应用微量分光光度法检测良、恶性肝病及胃肠道肿瘤３２７例血清ＡＦｕ活性。结果ＡＦｕ以ＨＣＣ组最高（６５４．７±２０４．６μｍｏｌ·Ｌ－１·ｈ－１），明显高于慢性肝炎（４１５．７±１６９．４）、肝硬变（４１２．５±１４６．８）、肝脏良性占位（３９０．４±１４３．１）、胃肠道恶性肿瘤（３９０．８±１７８．３）及正常对照（３８１．９±１１４．５），Ｐ＜０．０１。对ＨＣＣ诊断敏感性、特异性与ＡＦＰ相当，随访１＿５年发现１３例ＡＦｕ升高患者６例在６＿２８月内确诊为ＨＣＣ，早于ＡＦＰ阳性４＿８周。部分良性肝病ＡＦｕ升高均与肝功损害呈平行关系。ＡＦｕ在ＨＣＣ和胃肠道恶性肿瘤无明显重迭，在疗效分析中ＡＦｕ与ＡＦＰ相当，但早于ＡＦＰ１周时间。结论ＡＦｕ对ＨＣＣ特别是对早期ＡＦＰ阴性ＨＣＣ的诊断、鉴别。
AIMS To assess the clinical significance of serum α_L_fucosidase(AFu) as a marker for hepatocellular carcinoma(HCC). METHODS The AFu activity was microquantitatively measured by spectrophotometry in 62 patients with HCC, 56 liver cirrhosis(LC), 14 benign focal lesions(BFL), 20 chronic hepatitis(CH). 35 other malignant neoplasma(OMN), and 50 healthy subjects. RESULTS The serum AFu activity in HCC(654.7±204.6μmol·L -1 ·h -1 )was significantly higher than that in LC(415.7±169.8, P<0.01), BFL(390.4±143.1, P<0.01), CH(415.7±169.4, P<0.01), OMN(392.8±78.3, P<0.01), and healthy subjects (381.9±114.5, P<0.01) when 600μmol·L -1 ·h -1 was taken as the cutoff value. AFu sensitivity and specificity for diagnosing HCC were 74.2% and 91.4%, respectively. 60% of low AFP_producing HCC had AFu levels greater than cutoff value. Following_up of LC for 1_5 years, 6 in 13 cases of elevated AFu were diagnosed clinically as HCC. The positive AFu was found 4_8 weeks earlier than that of AFP. There was a remarkble relation between AFu and liver injury parameter in benign liver diseases. Serum AFu activity had minimal overlap between HCC and OMN. AFu activity fell to within the normal range after effective treatment for HCC patients. CONCLUSIONS AFu may be of important value in the early detection, differential diagnosis of HCC as well as in the servey of HCC.
关键词
肝癌
岩藻糖苷酶
血清诊断
fucosidase/blood carcinoma, hepatocellular/enzymology liver neoplasms/enzymology serodiagnosis
