Laboratory diagnostic methods for liver cancer

Laboratory diagnosis of liver cancer includes:

1. Alpha-fetoprotein (AFP) AFP is currently the most specific serum marker for diagnosing hepatocellular carcinoma. Its diagnostic and clinical value for liver cancer is as follows: ① Its specificity is second only to pathological diagnosis. In my country, 60%-70% of liver cancers have AFP higher than normal. Liver cancer can be diagnosed when AFP is greater than 400pcg/L for more than 1 month or 200pcg/L for more than 2 months, and pregnancy, active liver disease, and gonadal embryonal tumors are excluded. ② Early diagnosis can be made 6 to 12 months before symptoms appear. ③ A sensitive indicator that reflects the condition and efficacy. ④ It is conducive to the discovery of subclinical recurrence and metastasis.

2. Abnormal prothrombin DCP is a prothrombin precursor synthesized by the liver. Liver patients cannot convert it into prothrombin with coagulation activity and release it into the blood. The structural difference between it and normal prothrombin is that the amino acid residues distributed on the N-terminus are not carboxylated, so they cannot bind to calcium and phospholipids and lose their coagulation activity. Liver cancer tissue loses the expression of carboxylase genes, resulting in increased accumulation of DCP. The positive rate of DCP in diagnosing liver cancer is 69%, and 60% of AFP-negative liver cancers are positive. The combined use of DCP and AFP can increase the detection rate of AFP-negative or low-concentration positive liver cancers.

3. In more than 40% of liver cancer cases, the activity of GGT-Ⅱ is elevated, but it lacks specificity. The appearance of GGT-Ⅱ is not related to the level of AFP. The combined detection of the two can make the positive rate of liver cancer as high as 94%, which has the value of early diagnosis.

4.ar=L-fucosidase is a glycoprotein rich in sialic acid and a lysosomal enzyme. It is widely present in various tissues, organs and body fluids of the body and participates in the decomposition and metabolism of various biologically active substances such as glycoproteins and glycolipids. Increased fucose conversion in tumor tissue can lead to increased AFU levels in serum. The AFU in liver cancer tissue is lower than that in cancer tissue, indicating that the AFU produced by liver cancer tissue is quickly secreted into the blood, resulting in an increase in AFU in serum.

5. Alkaline phosphatase isoenzyme AIP is not specific for liver cancer diagnosis, because various liver diseases and jaundice can be accompanied by increased ALP activity. It can be used to differentiate primary liver cancer from metastatic liver cancer or benign liver disease.

6. Acidic isoferritin In liver disease, ferritin A escapes from damaged liver tissue, and the liver's ability to process ferritin is also reduced, which can cause elevated serum ferritin. The increase in patients with liver cancer is more obvious than in patients with benign liver disease, but there is overlap between the two, and the determination of total serum ferritin is not specific for liver cancer. Ferritin can be divided into three parts: alkaline, neutral, and acidic by using polyacrylamide and isoelectric focusing. Among them, acidic isoferritin is mostly believed to be produced by liver cancer cells and has a higher specificity for liver cancer.