中文摘要：

目的：探讨碱性磷酸酶（ALP）同工酶在肝癌和肝癌骨转移鉴别诊断中的应用。方法用等电聚焦法（IEF）分离测定80例健康体检者和153例肝脏疾病患者血清中的ALP同工酶。结果采用神经氨酸苷酶处理标本后，IEF能分辨出ALP同工酶pI6．0、pI6．1、pI6．4和pI6．5共4个亚型。ALP的pI6．0和pI6．4亚型的检出率在健康体检组、非肝癌组、肝癌组之间差异无统计学意义（P＞0．05）；pI6．5亚型的检出率在肝癌患者组明显高于健康体检组和非肝癌组（ P＜0．01）；pI6．1检出率在肝癌骨转移组明显高于肝癌无骨转移组、健康体检组和非肝癌组（ P＜0．01）。pI6．5用于肝癌诊断的灵敏度是60．7％，特异性是83．3％，阳性预测值是69．2％，阴性预测值是77．4％，符合率为74．7％。pI6．1用于肝癌骨转移的诊断灵敏度是70．0％，特异性是81．3％，阳性预测值是84．5％，阴性预测值是84．8％，符合率为77．6％。结论 IEF法能分离ALP同工酶不同亚型，pI6．5亚型可作为肝癌鉴别诊断指标，p I6．1亚型可作为肝癌骨转移鉴别诊断指标。

英文摘要：

Objective To investigate the application of alkaline phosphatase （ALP） isoenzymes detected by the agarose isoelectricfocusing （IEF） method in the differential diagnosis of liver cancer and bone metastasis of liver canc‐er .Methods The serum ALP isoenzyme level was detected in 80 people with healthy examination and 153 cases of liver diseases by the agarose IEF method .Results After treating the specimen by neuraminidase ,ALP isoenzymes subtypes of pI6 .0 ,pI6 .1 ,pI6 .4 and pI6 .5 could be identified by the agarose IEF .The detection rates of pI6 .0 and pI6 .4 had no statistical differences among the healthy group ,non‐liver cancer group and liver cancer group （ P〉0 .05）;the detection rate of pI6 .5 in the liver cancer group was significantly higher than that in the healthy control group and the non‐liver cancer group（P〈0 .01）;the detection rate of pI6 .1 in the liver cancer bone metastases group was significantly higher that in the liver cancer non‐bone metastases group ,the healthy group and the non‐liver cancer group（P〈0 .01） .The sensitivity ,specificity ,positive predictive value ,negative predictive value and coincidence rate of pI6 .5 for diagnosing liver cancer were 60 .7% ,83 .3% ,69 .2% ,77 .4% and 74 .7% respectively ;which of pI6 .1 for the diagnosis of liver cancer bone metastases were 70 .0% ,81 .3% ,84 .5% ,84 .8% and 77 .6% respectively .Con‐clusion The subtypes of ALP isoenzymes can be separated by the improved agarose IEF method .The subtype pI6 .5 can be used as a differential diagnosis indicator of liver cancer and the subtype pI6 .1 can be used as a differential di‐agnosis indicator of liver cancer bone metastases .