岩藻糖苷酶AFU偏高是怎么回事

2025-03-16 15:52:57
推荐回答(1个)
回答1:

看看这个:
α-L-岩藻糖苷酶(AFU)是一种溶酶体酸性水解酶,1980年法国学者Deugnier等研究发现,AFU在诊断肝细胞癌中敏感性好,阳性率高,是AFP阳性率的三倍以上,对AFP阴性病例及小细胞肝癌的诊断价值极大,是早期原发性肝癌诊断的有用指标。并被众多研究所证实。

一. 生化特性:AFU,主要参与含岩藻糖基的各种糖脂、糖蛋白、粘多糖等大分子物质的分解代谢。广泛存在于人体各组织细胞溶酶体和体液中。

二. 标本

血清、尿液、唾液、泪液等标本均可。标本应澄清,4℃保存3天,-20℃保存3个月,避免反复冻融。溶血、黄疸、高血脂、污染标本严重影响结果。

三. 临床意义

1.肝癌:原发性肝癌患者血清中AFU活性不仅显著高于正常对照,而且也显著高于转移性肝癌、胆管细胞、恶性间皮瘤、恶性血管内皮细胞瘤、肝硬化、先天性肝囊肿和其它良性肝占位性病变。对原发性肝癌诊断的阳性率为64%-84%,特异性达90%左右。通过对原发性肝癌、肝硬化患者进行AFU、AFP检测,发现原发性肝癌和肝硬化后肝癌患者AFU、AFP均增高,以AFP500ng/mL为诊断肝癌的临界值,其假阳性率为43%,AFU740nmol/(ml.h)为临界值,其敏感度为84%,特异性为94%。因此,血清AFU对原发性肝癌诊断有较高的敏感性和特异性。国内对24例肝细胞癌患者进行血清AFU和AFP相关研究,发现AFU诊断敏感必为87%,特异性为78%,而AFP则分别为65%和89%(诊断界限为,20ug/L)。提示AFU诊断的敏感性好,而特异性较AFP低。血清中AFU活性和阳性率与肝癌直径大小无明显相关性。小肝癌组血清AFU阳性率70.8%显著高于AFP(37.5%)。AFP阴性和AFP升高而不足以诊断原发性肝癌者,其血清AFU的阳性率达80.8%。肝组织活检证实为原发性肝癌者,血清AFU的阳性率为AFP阳性率的3倍以上。。在肝硬化患者中检测AFU,如其活性增加,对发现一些较小的肿瘤更具有价值,此时AFP不能对较小的肿瘤做出诊断。因此,应用和推广AFU作为原发性肝癌新的诊断指标,具有重要的意义,尤其是AFP阴性和小细胞肝癌的诊断价值更大。因与AFP无明显相关可互初诊断,联合检测可提高肝癌的检出率

2.妊娠与卵巢肿瘤:研究表明,随妊娠周数增加血浆AFU递增,在自然分娩或人工终止妊娠后,迅速下降,5天降到正常。卵巢癌患者血清AFU活性降低,且与疾病分期、肿瘤负荷、组织学分型和肿瘤分化程度无关。良恶性卵巢癌患者血清AFU活性降低可能与遗传因素有关

3.其它:岩藻糖苷酶贮积患者由于先天性组织器官和体液中AFU缺乏或活力降低,导致糖蛋白或糖脂代谢紊乱。胃癌患者血清AFU升高,急性胰腺炎不升高,囊性纤维变性伴发胰腺炎时则下降,进行性锥体营养不良 血清AFU活性下降

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