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摘要：
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摘要：目的 探讨甲胎蛋白异质体L3（alpha-fetoprotein heterogeneity L3，AFP-L3）对早期原发性肝
癌（primary liver cancer，PLC）的诊断价值。方法 选取2016年1月至2016年12月于首都医科大学附
属北京地坛医院住院的150例患者为研究对象，其中慢性肝炎（chronic hepatitis，CH）患者32例（慢
性乙型肝炎患者26例，慢性丙型肝炎患者6例）、肝硬化（liver cirrhosis，LC）患者45例，早期PLC
患者73例，比较各组患者的AFP及AFP-L3%水平并进行相关性分析。结果 PLC组患者AFP-L3%为
（19.70 ± 13.47）%，显著高于肝硬化组[（9.57 ± 5.28）%]与慢性肝炎组[（7.85 ± 4.41%）]，差异有
统计学意义（F = 8.661，P = 0.001）。在所有患者中，AFP ＞ 20 ng/ml诊断早期PLC的敏感性、特
异性、阳性预测值、阴性预测值分别为67.1%（49/73）、62.3%（48/77）、62.8%（49/78）和66.7%
（48/72）；AFP-L3% ＞ 10%诊断早期PLC的敏感性、特异性、阳性预测值、阴性预测值分别为
72.6%（53/73）、83.1%（64/77）、80.3%（53/66）和76.2%（64/84），AFP-L3%诊断早期PLC的特
异性和阳性预测值均显著高于AFP，差异有统计学意义（χ 2 = 5.271、4.390，P = 0.028、0.047）。结
论 AFP-L3%诊断早期PLC的特异性及阳性预测值显著高于AFP，对早期PLC的诊断及鉴别诊断具有
重要意义。
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Abstract: Objective To investigate the diagnostic value of alpha-fetoprotein heterogeneity L3 (AFP-L3) on
early primary liver cancer (PLC). Methods A total of 150 patients in Beijing Ditan Hospital, Capital Medical
University from January 2016 to December 2016 were selected. There were 32 patients with chronic hepatitis
(CH) (26 cases were with chronic hepatitis B and 6 cases were with chronic hepatitis C), 45 patients with liver
cirrhosis (LC) and 73 patients with early PLC. AFP and AFP-L3% were compared among different groups.
The correlation between AFP and AFP-L3% was also analyzed. Results AFP-L3% of patients in early PLC
group was (19.70 ± 13.47)%, which was significantly higher than those in LC group [(9.57 ± 5.28)%] and CH
group [(7.85 ± 4.41)%], the differences were statistically significant (F = 8.661, P = 0.001). In all patients, the
sensitivity, specificity, positive predictive value and negative predictive value of AFP ＞ 20 ng/ml on early
PLC were 67.1%, 62.3%, 62.8% and 66.7%, respectively. The sensitivity, specificity, positive predictive value
and negative predictive value of AFP-L3% ＞ 10% on early PLC were 72.6%, 83.1%, 80.3% and 76.2%,
respectively. The specificity and positive predictive value of AFP-L3% were significantly higher than those
of AFP (χ 2 = 5.271, 4.390; P = 0.028, 0.047). Conclusions The specificity and predictive positive rate of
AFP-L3% in the diagnosis of early primary liver cancer were higher than those of AFP. AFP-L3% played an
important role in the diagnosis and differential diagnosis of early primary liver cancer.
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