TPA或TPS联合蛋白芯片检测系统对原发性肝癌的诊断价值

Diagnostic value of protein biochip detective system combined with TPA or TPS for primary hepatic cancer

目的:研究组织多肽抗原(tissue polypeptide antigen, TPA)或组织多肽特异性抗原(tissue polypeptide specific antigen, TPS)联合蛋白芯片检测系统对原发性肝癌(primary hepatic cancer, PHC)的诊断价值.方法:用C-12蛋白芯片检测系统测定分析50例PHC患者、34例肝硬化患者、32例肝炎患者以及42例正常人体血清中6种常见肿瘤标志物(CA199、CEA、CA242、AFP、CA125及CA153)的水平,同时应用酶联免疫吸附试验(enzyme-linked immunosorbent assay, ELISA)检测TPA和TPS的水平.结果:C-12蛋白芯片对PHC的敏感性为86.0%,特异性为72.2%.应用ROC曲线确定TPA和TPS的最佳切割值分别为2.0 μg/L和180 U/L.在此切割值下,TPA和TPS对PHC的敏感性为80.0%和72.0%,特异性为73.0%和75.7%.TPA或TPS联合C-12蛋白芯片可以将PHC的诊断敏感性提高至92.0%～94.0%,对临床Ⅰ、Ⅱ期PHC的敏感性分别达到77.8%和66.7%,但特异性下降至58.3%～61.1%.结论:TPA或TPS联合C-12蛋白芯片可以提高PHC诊断的敏感性和阴性预测值,减少漏诊率,并且对PHC的早期诊断具有一定的意义.由于该法特异性及阳性预测值偏低,所以更适合于无明显症状的门诊患者和PHC高危人群的筛查.

OBJECTIVE:To evaluate the diagnostic value of protein biochip detective system combined with TPA or TPS for primary hepatic cancer (PHC).METHODS: The serum levels of 6 common used tumor markers, including CA199, CEA, CA242, AFP, CA125 and CA153, were measured with the C-12 protein biochip detective system in 50 PHC patients, 34 patients with liver cirrhosis, 32 patients with chronic hepatitis and 42 healthy persons, and serum TPA and TPS levels were detected by ELISA.RESULTS:The positive rate of the system for PHC was 86.0% while specificity was 72.2%. The best Cut-off values of TPA and TPS for the diagnosis of PHC were 2.0 μg/L and 180 U/L by using ROC curve. The sensitivities of TPA and TPS were 80.0% and 72.0%, and specificities were 73.0% and 75.7%. Combined measurement of TPA or TPS and the system increased the diagnostic sensitivity to 92.0%-94.0%, especially for StageⅠand Stage Ⅱ PHC, and the sensitivity were 77.8% and 66.7%.However, the specificity decreased to 58.3%-61.1%. CONCLUSIONS: Combination of TPA or TPS with the C-12 protein biochip can increase the diagnostic sensitivity and negative predictive value, especially for the diagnosis of Stage Ⅰand Stage Ⅱ PHC. As its specificity and positive predictive value were lower, it was more suitable to be used as a surveying tool to symptomless patients, especially to high risk PHC people.