摘要：目的 探讨超声造影法和D-二聚体、AFP-L3水平的检测对原发性肝癌诊断准确性的差异，对比三种诊断方法，以提高对原发性肝癌的早期诊断的准确性。方法 对50例原发性肝癌患者分别进行超声造影检查，D-二聚体和AFP-L3水平的测定，比较三种诊断方式的真阳性率。结果 超声、D-二聚体和AFP-L3对原发性肝癌的确诊率分别为76%、54%、74%；超声和AFP-L3的确诊率较高，D-二聚体的漏误诊率较高，三者之间的待定率无显著性差异。超声和AFP-L3两项联合检测的敏感性及特异性与三项联合检测无显著性差异（P>0.05）。三项联合检测的敏感性与超声、D-二聚体单独检测有显著性差异（P<0.05），联合检测的特异性与单独检测也有显著性差异（P<0.05）。结论 在临床上可优先选择超声或AFP-L3进行检测，必要时候两者进行联合检测，或再联合检测D-二聚体，提高对原发性肝癌的早期确诊率，降低漏误诊率。

Abstract: Objective To investigate the difference of ultrasound and detection of two D-dimer, AFP-L3 levels on the diagnostic accuracy of primary hepatocellular carcinoma. Methods 50 cases of primary liver cancer patients were performed contrast enhanced ultrasound examination, the D-dimer and AFP-L3 levels in patient were detected. Results The diagnostic rate of primary hepatocellular carcinoma with Ultrasound, D-dimer and AFP-L were 76%, 54% and 74% respectively. The AFP-L3 level and ultrasound diagnosis had higher detection rate but no significantly difference between these three methods (P>0.05). The sensitivity and specificity of combined ultrasound, D-dimer and AFP-L3 levels detection in the diagnosis of primary hepatocellular carcinoma were higher than any single method (P<0.05). Conclusion The ultrasound and AFP-L3 level detection may be prefer method in clinic, and combined ultrasound with D-dimer and AFP-L3 level detection might improve the early diagnosis rate of primary liver cancer.