高尔基体蛋白73联合甲胎蛋白异质体在原发性肝癌诊断中的价值

Values of Golgi protein 73 and Alpha-fetoprotein-L3 in the diagnosis of primary hepatic carcinoma

目的探讨高尔基体蛋白73(GP73)与甲胎蛋白异质体(AFP-L3)联合检测在乙型肝炎病毒相关性肝癌诊断中的价值。方法收集132例血清,其中原发性肝癌(PHC)56例、肝硬化33例,慢乙肝患者23例,健康对照20例,酶联免疫吸附法(ELISA)检测各组GP73的表达情况;应用甲胎蛋白异质体亲和吸附离心管洗脱获得AFP-L3,同时化学发光法检测原始血清中总AFP和AFP-L3,计算AFP-L3在总AFP中的比率。结果 PHC组、肝硬化组、肝炎组及健康对照组血清GP73水平分别为247.05(228.35～287.72)、176.83(159.51～183.98)、152.58(135.19～162.85)、43.00(37.96～52.64)ng/mL,AFP-L3%分别为14.52(12.33～15.28)%、5.68(4.32～7.74)%、4.31(3.57～6.45)%、3.29(2.60～4.25)%。PHC组GP73和AFP-L3%均明显高于其他组(P均<0.01);GP73和AFP-L3%用于诊断PHC的ROC曲线下面积分别为0.825、0.828,最佳截取值分别为187.60 ng/mL、9.98%,此时的敏感度分别为69.6%、64.3%,特异度分别为86.8%、96.1%。二者联合诊断PHC的敏感度为82.1%,特异度为85.5%。结论 GP73和AFP-L3%均可作为诊断PHC的血清标记物,二者联合检测具有更高的灵敏度,可提高PHC的诊断率。

Objective To explore significances of Golgi protein 73（GP73） and Alpha-fetoprotein variant（AFP-L3） in the diagnosis of hepatitis B virus-related primary hepatic carcinoma（PHC）.Methods Enzyme-linked immunosorbent assay（ELISA） was used to detect the serum level of GP73 in 56 cases of PHC,33 cases of liver cirrhosis,23 cases of chronic hepatitis B and 20 healthy controls.AFP-L3 was isolated by using affinity microcentrifugalcolumn;AFP and AFP-L3 were detected with chemiluminescent immunoassay and then the proportion of AFP-L3 was calculated.Results Serum GP73 levels in the PHC,liver cirrhosis,chronic hepatitis and healthy groups were 247.05（228.35~287.72）,176.83（159.51~183.98）,152.58（135.19~162.85） and 43.00（37.96~52.64）ng/mL,respectively,and AFP-L3% was 14.52（12.33~15.28）%,5.68（4.32~7.74）%,4.31（3.57~6.45）% and 3.29（2.60~4.25）%,respectively.GP73 and AFP-L3% levels were significantly higher in patients with PHC compared with those in other groups（P0.01）.Areas under the ROC curves of GP73 and AFP-L3% were 0.825 and 0.828,respectively,and optimal cut-off values were 187.60 ng/mL and 9.98% when diagnosing PHC,with sensitivities of 69.6% and 64.3% and specificities of 86.8% and 96.1%.Combined detection of the two parameters could improve the sensitivity up to 82.1% and maintain a high specificity of 85.5%.Conclusion Both serum GP73 and AFP-L3% could be used as biomarkers in the diagnosis of PHC,and combined detection of them could improve diagnostic accuracy,with a higher sensitivity.