血清GPC3对原发性肝细胞癌的诊断价值

Clinical Value of Glypican-3 in the Diagnosis of Primary Hepatocellular Carcinoma

目的 研究血清磷脂酰肌醇硫酸类肝素蛋白聚糖3（glypican-3,GPC3）对原发性肝细胞癌（hepatocellular carcinoma,HCC）的诊断价值.方法 检测46例肝硬化患者和44例HCC患者的血清GPC3和AFP水平,血清GPC3测定采用酶联免疫吸附法（ELISA）,血清AFP测定采用微粒子酶免疫分析法（MEIA）,统计分析GPC3和AFP单独使用及联合检测对HCC患者诊断的灵敏度和特异度.结果 HCC组的血清GPC3和AFP浓度分别为611.09 ng/L和958.37 ng/ml,均明显高于肝硬化组（190.53 ng/L和55.12 ng/ml）（P〈0.05）.GPC3和AFP的浓度之间无相关关系.AFP阴性的HCC患者15例中GPC3阳性者6例,GPC3阴性的HCC组患者17例中AFP阳性者8例.AFP联合GPC3检测用于HCC诊断的灵敏度（79.54%）优于AFP（65.91%）及GPC3单独使用（61.36%）.GPC3浓度与HCC病灶大小、PVI浸润和HBV感染均无相关关系（P〉0.05）.结论 GPC3对于HCC具有与AFP相似的诊断价值,GPC3可以协同AFP的诊断作用,二者联合检测能明显提高HCC诊断率.

Objective To evaluate the clinical value of the serum levels of Glypican 3（GPC3） in the diagnosis of hepatocellular carcinoma （HCC）. Methods 90 patients were enrolled in this study, including /14 patients with HCC and 46 patients with liver cirrhosis. Serum GPC3 levels were detected by ELISA and AFP by ME1A. Sensitivity and specificity were performed to evaluate the diagnosis effect of 2 biomarkers in hepatocellular carcinoma as well as their combined measurement effect. Resuits The serum levels of GPC3 and AFP in HCC patients were 611.09 ng/L and 958. 37 ng/ml respectively,hlgher than those in liver cirrhosis （190.53 ng/L,S5.12 ng/ml respectively） （P〈0.05）. In most cases,elevated GPC3 values did not correlated with elevated AFP values. Among the 15 AFP negative patients with HCC,there were 6 patients with GPC3 positive. Among the 17 GPC3 negative patients with HCC,there were 8 patients with AFP positive. The sensitivity of combined measurement of GPC3 and AFP （79.54%） was better than GPC3 or AFP alone （61.36% ,65.91% respectively）. GPC3 expression was independent of the size of the hepatocellular carcinoma,PVI and the infection of HBV. Conclusion GPC3 was a sensitive serum marker as AFP for diagnosis of HCC. It may be a good supplement to the AFP in discriminating HCC from benign liver disease.