多学科甲胎蛋白异质体临床应用专家共识
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摘要
<正>甲胎蛋白(alpha-fetoprotein,AFP)是目前临床应用最广泛的肝癌辅助诊断血清标志物。AFP诊断肝癌的敏感性为60%~70%;但在肝脏良性疾病患者,特别是肝癌高危(如慢性肝炎、肝硬化)患者中,也有部分患者会出现AFP升高。妇女孕期及某些生殖系统疾病时,AFP也会升高[1]。
引文
[1]中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)[J].临床肿瘤学杂志,2011,16(10):929-946.
[2]Kokudo N,Hasegawa K,Akahane M,et al.Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma:The Japan Society of Hepatology 2013 update(3rd JSH-HCC Guidelines)[J].Hepatol Res,2015,45(2):123-127.
[3]Hoofnagle JH,Doo E,Liang TJ,et al.Management of hepatitis B:summary of a clinical research workshop[J].Hepatology,2007,45(4):1056-1075.
[4]Ganem D,Prince AM.Hepatitis B virus infection--natural history and clinical consequences[J].N Engl J Med,2004,350(11):1118-1129.
[5]Thein H H,YiQ,Dore G J,etal.Estimation of stage-specific fibrosis progression rates in chronic hepatitis C virus infection:a meta-analysis and meta-regression[J].Hepatology,2008,48(2):418-431.
[6]EL-Serag HB,RUDOLPH KL.Hepatocellular carcinoma:epidemiology and molecular carcinogenesis[J].Gastroenterology,2007,132(7):2557-2576.
[7]Sato Y,Nakata K,Kato Y,et al.Early recognition of hepatocellularcarcinoma based on altered profiles of alpha-fetoprotein[J].N Engl J Med,1993,328(25):1802-1806.
[8]Hu B,Tian X,Sun J,et al.Evaluation of individual and combined applications of serum biomarkers for diagnosis of hepatocellular carcinoma:a meta-analysis[J].Int J Mol Sci,2013,14(12):23559-23580.
[9]Hadziyannis E,Sialevris K,Georgiou A,et al.Analysis of serumα-fetoprotein-L3%and des-γcarboxyprothrombin markers in cases with misleading hepatocellular carcinoma totalα-fetoprotein levels[J].Oncol Rep,2013,29(2):835-839.
[10]Song P,Feng X,Zhang K,et al.Perspectives on using des-γ-carboxyprothrombin(DCP)as a serum biomarker:facilitating early detection of hepatocellularcarcinoma in China[J].Hepatobiliary Surg Nutr,2013,2(4):227-231.
[11]Kumada T,Toyoda H,Tada T,et al.High-sensitivity Lens culinaris agglutinin-reactive alpha-fetoprotein assay predicts early detection of hepatocellular carcinoma[J].J Gastroenterol,2014,49(3):555-563.
[12]Tateishi R,Yoshida H,Matsuyama Y,et al.Diagnostic accuracy of tumor markers for hepatocellular carcinoma:a systematic review[J].Hepatol Int,2008,2(1):17-30.
[13]Toyoda H,Kumada T,Tada T.Highly sensitive Lens culinaris agglutinin-reactiveα-fetoprotein:a new tool for the management of hepatocellular carcinoma[J].Oncology,2011,81 Suppl1:61-65.
[14]Thomas MB,Jaffe D,Choti MM,et al.Hepatocellular carcinoma:consensus recommendations of the National Cancer Institute Clinical Trials Planning Meeting[J].J Clin Oncol,2010,28(25):3994-4005.
[15]Hanaoka T,Sato S,Thbita H,et al.Clinical significance of the highly sensitive fucosylated fraction ofα-fetoprotein in patients with chronic liver disease[J].J Gastroenterol Hepatol,2011,26(4):739-744.
[16]Volk ML,Hernandez JC,Su GL,et al.Risk factors for hepatocellular carcinoma may impair the performance of biomarkers:a comparison of AFP,DCPand AFP-L3[J].Cancer Biomark,2007,3(2):79-87.
[17]Marrero JA,Feng Z,Wang Y,et al.Alpha-fetoprotein,des-gamma carboxyprothrombin,and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma[J].Gastroenterology,2009,137(1):110-118.
[18]徐万菊,韩玉刚,张芊,等.甲胎蛋白异质体与高尔基体蛋白73在甲胎蛋白低浓度肝细胞癌诊断中的意义[J].中华检验医学杂志,2012,35(2):174-176.
[19]胡敏华,陈燕,梁亚嘉,等.新微量离心柱法测定甲胎蛋白异质体对原发性肝癌诊断的价值(附297例分析)[J].福建医药杂志,2009,31(4):95-96.
[20]徐恩君,陈秋莉,李涛,等.血清AFP、AFP-L3联合检测在原发性肝癌中的诊断价值[J].安徽医科大学学报,2016,51(7):1066-1070.
[21]季君,顾星,高致远,等.凝集素微量离心柱法检测甲胎蛋白异质体在原发性肝癌中的应用评价[J].检验医学,2011,26(4):256-259.
[22]Okuda H,Saito A,Shiratori K,et al.Clinicopathologic features of patients with primary malignant hepatic tumors seropositive for alpha-fetoprotein-L3alone in comparison with other patients seropositive for alpha-fetoprotein-L3[J].J Gastroenterol Hepatol,2005,20(5):759-764.
[23]Tada T,Kumada T,Toyoda H,et al.Relationship between Lens culinaris agglutinin-reactive alpha-fetoprotein and pathologic features of hepatocellular carcinoma[J].Liver Int,2005,25(4):848-853.
[24]Okuda H,Nakanishi T,Takatsu K,et al.Clinicopathologic features of patients with hepatocellular carcinoma seropositive for alpha-fetoprotein-L3 and seronegative for des-gamma-carboxy prothrombin in comparison with those seropositive for des-gamma-carboxy prothrombin alone[J].J GastroenterolHepatol,2002,17(7):772-778.
[25]Matsuda M,Asakawa M,Amemjya H,et al.Lens culinaris agglutinin-reactive fraction of AFP is a useful prognostic biomarker for survival after repeat hepatic resection for HCC[J].J Gastroenterol Hepatol,2011,26(4):731-738.
[26]Saito Y,Shimada M,Utsunomiya T,et al.Prediction of recurrence of hepatocellular carcinoma after curative hepatectomy using preoperative Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein[J].Hepatol Res,2012,42(9):887-894.
[27]Kiriyama S,Uchiyama K,Ueno M,et al.Triple positive tumor markers for hepatocellular carcinoma are useful predictors of poor survival[J].Ann Surg,2011,254(6):984-991.
[28]Nakagawa S,Beppu T,Okabe H,et al.Triple positive tumor markers predict recurrence and survival in early stage hepatocellular carcinoma[J].Hepatol Res,2014,44(9):964-974.
[29]Kobayashi M,Hosaka T,Ikeda K,et al.Highly sensitive AFP-L3%assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre-and postoperatively[J].Hepatol Res,2011,41:373-379.
[30]Wang FS,Fan JG,Zhang Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.
[31]Fattovich G,Stroffolini T,Zagni I,et al.Hepatocellular carcinoma in cirrhosis:incidence and risk factors[J].Gastroenterology,2004,127:S35-S50.
[32]Okuda H,Shiratori K,Yamamoto M,et al.Clinicopathologic features of patients with intrahepatic cholangiocarcinoma who are seropositive for alpha-fetoprotein-L3 and those with combined hepatocellular and cholangiocarcinoma[J].J Gastroenterol Hepatol,2006,21(5):869-873.
[33]Choi J,Park Y,Kimj-H,et al.Evaluation of revisited fucosylated alpha-fetoprotein(AFP-L3)with an autoanalyzerμTAS in a clinical laboratory[J].Clin Chim Acta,2012,413:170-174.
[34]Kurosawa T,Watanabe M.Development of on-chip fully automated immunoassay system“μTASWako i30”to measure the changes in glycosylation profiles of alpha-fetoprotein in patients with hepatocellular carcinoma[J].Proteomics,2016,16(24):3056-3061.
[2]Kokudo N,Hasegawa K,Akahane M,et al.Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma:The Japan Society of Hepatology 2013 update(3rd JSH-HCC Guidelines)[J].Hepatol Res,2015,45(2):123-127.
[3]Hoofnagle JH,Doo E,Liang TJ,et al.Management of hepatitis B:summary of a clinical research workshop[J].Hepatology,2007,45(4):1056-1075.
[4]Ganem D,Prince AM.Hepatitis B virus infection--natural history and clinical consequences[J].N Engl J Med,2004,350(11):1118-1129.
[5]Thein H H,YiQ,Dore G J,etal.Estimation of stage-specific fibrosis progression rates in chronic hepatitis C virus infection:a meta-analysis and meta-regression[J].Hepatology,2008,48(2):418-431.
[6]EL-Serag HB,RUDOLPH KL.Hepatocellular carcinoma:epidemiology and molecular carcinogenesis[J].Gastroenterology,2007,132(7):2557-2576.
[7]Sato Y,Nakata K,Kato Y,et al.Early recognition of hepatocellularcarcinoma based on altered profiles of alpha-fetoprotein[J].N Engl J Med,1993,328(25):1802-1806.
[8]Hu B,Tian X,Sun J,et al.Evaluation of individual and combined applications of serum biomarkers for diagnosis of hepatocellular carcinoma:a meta-analysis[J].Int J Mol Sci,2013,14(12):23559-23580.
[9]Hadziyannis E,Sialevris K,Georgiou A,et al.Analysis of serumα-fetoprotein-L3%and des-γcarboxyprothrombin markers in cases with misleading hepatocellular carcinoma totalα-fetoprotein levels[J].Oncol Rep,2013,29(2):835-839.
[10]Song P,Feng X,Zhang K,et al.Perspectives on using des-γ-carboxyprothrombin(DCP)as a serum biomarker:facilitating early detection of hepatocellularcarcinoma in China[J].Hepatobiliary Surg Nutr,2013,2(4):227-231.
[11]Kumada T,Toyoda H,Tada T,et al.High-sensitivity Lens culinaris agglutinin-reactive alpha-fetoprotein assay predicts early detection of hepatocellular carcinoma[J].J Gastroenterol,2014,49(3):555-563.
[12]Tateishi R,Yoshida H,Matsuyama Y,et al.Diagnostic accuracy of tumor markers for hepatocellular carcinoma:a systematic review[J].Hepatol Int,2008,2(1):17-30.
[13]Toyoda H,Kumada T,Tada T.Highly sensitive Lens culinaris agglutinin-reactiveα-fetoprotein:a new tool for the management of hepatocellular carcinoma[J].Oncology,2011,81 Suppl1:61-65.
[14]Thomas MB,Jaffe D,Choti MM,et al.Hepatocellular carcinoma:consensus recommendations of the National Cancer Institute Clinical Trials Planning Meeting[J].J Clin Oncol,2010,28(25):3994-4005.
[15]Hanaoka T,Sato S,Thbita H,et al.Clinical significance of the highly sensitive fucosylated fraction ofα-fetoprotein in patients with chronic liver disease[J].J Gastroenterol Hepatol,2011,26(4):739-744.
[16]Volk ML,Hernandez JC,Su GL,et al.Risk factors for hepatocellular carcinoma may impair the performance of biomarkers:a comparison of AFP,DCPand AFP-L3[J].Cancer Biomark,2007,3(2):79-87.
[17]Marrero JA,Feng Z,Wang Y,et al.Alpha-fetoprotein,des-gamma carboxyprothrombin,and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma[J].Gastroenterology,2009,137(1):110-118.
[18]徐万菊,韩玉刚,张芊,等.甲胎蛋白异质体与高尔基体蛋白73在甲胎蛋白低浓度肝细胞癌诊断中的意义[J].中华检验医学杂志,2012,35(2):174-176.
[19]胡敏华,陈燕,梁亚嘉,等.新微量离心柱法测定甲胎蛋白异质体对原发性肝癌诊断的价值(附297例分析)[J].福建医药杂志,2009,31(4):95-96.
[20]徐恩君,陈秋莉,李涛,等.血清AFP、AFP-L3联合检测在原发性肝癌中的诊断价值[J].安徽医科大学学报,2016,51(7):1066-1070.
[21]季君,顾星,高致远,等.凝集素微量离心柱法检测甲胎蛋白异质体在原发性肝癌中的应用评价[J].检验医学,2011,26(4):256-259.
[22]Okuda H,Saito A,Shiratori K,et al.Clinicopathologic features of patients with primary malignant hepatic tumors seropositive for alpha-fetoprotein-L3alone in comparison with other patients seropositive for alpha-fetoprotein-L3[J].J Gastroenterol Hepatol,2005,20(5):759-764.
[23]Tada T,Kumada T,Toyoda H,et al.Relationship between Lens culinaris agglutinin-reactive alpha-fetoprotein and pathologic features of hepatocellular carcinoma[J].Liver Int,2005,25(4):848-853.
[24]Okuda H,Nakanishi T,Takatsu K,et al.Clinicopathologic features of patients with hepatocellular carcinoma seropositive for alpha-fetoprotein-L3 and seronegative for des-gamma-carboxy prothrombin in comparison with those seropositive for des-gamma-carboxy prothrombin alone[J].J GastroenterolHepatol,2002,17(7):772-778.
[25]Matsuda M,Asakawa M,Amemjya H,et al.Lens culinaris agglutinin-reactive fraction of AFP is a useful prognostic biomarker for survival after repeat hepatic resection for HCC[J].J Gastroenterol Hepatol,2011,26(4):731-738.
[26]Saito Y,Shimada M,Utsunomiya T,et al.Prediction of recurrence of hepatocellular carcinoma after curative hepatectomy using preoperative Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein[J].Hepatol Res,2012,42(9):887-894.
[27]Kiriyama S,Uchiyama K,Ueno M,et al.Triple positive tumor markers for hepatocellular carcinoma are useful predictors of poor survival[J].Ann Surg,2011,254(6):984-991.
[28]Nakagawa S,Beppu T,Okabe H,et al.Triple positive tumor markers predict recurrence and survival in early stage hepatocellular carcinoma[J].Hepatol Res,2014,44(9):964-974.
[29]Kobayashi M,Hosaka T,Ikeda K,et al.Highly sensitive AFP-L3%assay is useful for predicting recurrence of hepatocellular carcinoma after curative treatment pre-and postoperatively[J].Hepatol Res,2011,41:373-379.
[30]Wang FS,Fan JG,Zhang Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.
[31]Fattovich G,Stroffolini T,Zagni I,et al.Hepatocellular carcinoma in cirrhosis:incidence and risk factors[J].Gastroenterology,2004,127:S35-S50.
[32]Okuda H,Shiratori K,Yamamoto M,et al.Clinicopathologic features of patients with intrahepatic cholangiocarcinoma who are seropositive for alpha-fetoprotein-L3 and those with combined hepatocellular and cholangiocarcinoma[J].J Gastroenterol Hepatol,2006,21(5):869-873.
[33]Choi J,Park Y,Kimj-H,et al.Evaluation of revisited fucosylated alpha-fetoprotein(AFP-L3)with an autoanalyzerμTAS in a clinical laboratory[J].Clin Chim Acta,2012,413:170-174.
[34]Kurosawa T,Watanabe M.Development of on-chip fully automated immunoassay system“μTASWako i30”to measure the changes in glycosylation profiles of alpha-fetoprotein in patients with hepatocellular carcinoma[J].Proteomics,2016,16(24):3056-3061.