GP73和AFP诊断HBSAg阳性原发性肝癌评价

Determination of Golgi protein 73 and Alpha-fetoprotein in the diagnosis of HBsAg^+ hepatocellular carcinoma

目的探讨血清高尔基体蛋白73(GP73)和甲胎蛋白(AFP)检测在HBSAg阳性原发性肝癌诊断中的价值。方法对30例健康体检者,32例慢性乙型病毒性肝炎、36例乙肝肝硬化及57例原发性肝癌(HBSAg阳性)患者分别采用酶联免疫吸附试验和微粒子酶免疫分析技术检测血清GP73和AFP含量,并对检测结果进行统计学分析。结果原发性肝癌(HBSAg阳性)患者血清GP73和AFP水平均显著高于其他疾病组及正常对照组(均<0.05)。GP73和AFP诊断HCC的ROC曲线下面积(AUC)为0.862和0.729,95%置信区间为0.796～0.913和0.650～0.799。GP73的最佳诊断界限值为145 ng/ml,其预测的灵敏度为70.18%,特异度为93.33%。GP73的AUC大于AFP的AUC,两者AUC的差异有统计学意义(<0.01)。结论血清GP73对HBSAg阳性原发性肝癌的诊断价值可能优于AFP,可作为一项较好的诊断HCC的血清标志物。

Objective To explore the clinical diagnostic value of Golgi protein 73（GP73） and alpha-fetoprotein（AFP） for hepatocellular carcinoma（HCC） patients with HBsAg＋.MethodsTThe serum GP73 and AFP were detected by enzyme-linked immunosorbent assay and microparticle chemiluminescent immunoassay in 32 patients infected with Hepatitis B virus hepatitis,36 cases of cirrhosis,57 cases of hepatocellular carcinoma）and 30 healthy controls.Then a statistical analysis was made on these results.ResultsTIn the patients with HCC（HBsAg＋）,the serum levels of GP73 and AFP were significantly higher than those in other patients and normal controls（all P0.05）,and the area under curve（AUC） generated by the ROC curves was 0.862（95%CI： 0.796～0.913） for GP73 and 0.729（95%CI： 0.650～0.799） for AFP.The best diagnostic threshold of GP73 was 145 ng/ml,and its sensitivity and specificity were 70.18% and 93.33%.The AUC of GP73 was bigger than that of AFP,and the difference was statistically significant（P0.01）.ConclusionsThe clinical diagnosis value of GP73 may be better than that of AFP,and GP73 could be a good serum marker in the diagnosis of hepatocellular carcinoma.