外周血磷脂酰肌醇蛋白聚糖-3检测在原发性肝癌诊断中的意义

Significance of serum glypican-3 protein determination in diagnosis of primary carcinoma of liver

目的探讨外周血磷脂酰肌醇蛋白聚糖-3(GPC3)检测在原发性肝癌诊断中的意义。方法应用酶联免疫吸附试验检测80例原发性肝癌患者、78例肝内良性占位病变患者和40例健康对照者外周血GPC3蛋白水平,了解GPC3蛋白在各组中的阳性率,探讨GPC3蛋白诊断原发性肝癌的敏感性和特异性。结果健康对照组血清GPC3蛋白水平为(196.76±112.24)pg/mL,肝内良性占位组为(248.56±123.35)pg/mL,原发性肝癌组为(678.23±325.22)pg/mL。原发性肝癌组血清GPC3蛋白水平高于肝内良性占位组和正常对照组(F=18.76,P<0.01)。根据ROC曲线,若外周血GPC3蛋白诊断原发性肝癌的界值为412.6 pg/mL,则敏感度为63.2%,特异度为89.3%,健康对照者GPC3蛋白阳性率为2.50%,肝内良性占位病变组阳性率为14.1%,原发性肝癌组阳性率为65.0%。各组间血清GPC3蛋白阳性率统计学差异有显著性意义(χ2=40.28,P<0.01)。若AFP诊断肝癌的截止值为400 ng/mL,AFP的阳性率为46.3%,联合检测AFP和GPC3的阳性率提高至77.5%。结论 GPC3蛋白可作为原发性肝癌诊断及鉴别诊断的重要指标之一。联合检测GPC3和AFP可能提高原发性肝癌的诊断敏感性。

【Objective】 To investigate the significance of serum glypican-3 protein determination in the diagnosis of primary carcinoma of liver.【Methods】 The levels of serum glypican-3 protein were measured by enzyme linked immunosorbent assay in 80 patients with primary carcinoma of liver,78 patients with focal liver lesions and 40 normal controls.The positive rates of serum glypican-3 protein in different groups were investigated.The cutoff value of serum glypican-3 protein was defined for the diagnosis of primary carcinoma of liver.The sensitivity and specificity of glypican-3 protein for the diagnosis of primary carcinoma of liver were studied.【Results】 The results showed that the levels of serum glypican-3 protein were（196.76±112.24） pg/mL,（248.56±123.35） pg/mL and（678.23±325.22） pg/mL in normal controls,focal liver lesion group and liver cancer group,respectively.The concentration of serum glypican-3 protein was significantly higher in liver cancer group than those in other two groups（F =18.76,P 0.01）.If the cutoff value of serum glypican-3 protein for the diagnosis of primary carcinoma of liver was 412.6 pg/mL,the sensitivity and specificity of glypican-3 protein for the diagnosis of primary carcinoma of liver were 63.2% and 89.3%,respectively.The positive rate of glypican-3 protein in the patients with primary carcinoma of liver was 65.0% and significantly higher than those in focal liver lesion group（14.1%） and normal group（2.50%）（χ2=40.28,P 0.01）.If the cutoff value of serum alpha fetoprotein was defined as 400 ng/mL,the positive rate of alpha fetoprotein in the patients with primary carcinoma of liver was 46.3%.The detection rate of simultaneous determination of glypican-3 protein and alpha fetoprotein increased to 77.5%.【Conclusion】 Serum glypican-3 protein may be a novel serum marker in the diagnosis and differential diagnosis of primary carcinoma of liver.The simultaneous detection of serum glypican-3 protein and alpha fetoprotein may significantly increase the sensitivity for the diagnosis of primary carcinoma of liver.