高尔基蛋白73（GP73）在原发性肝癌中的诊断价值

目的评价高尔基蛋白（GP73）在原发性肝癌诊断中的价值。方法选择肝癌患者93例，对照人群共71例（包括健康人，肝硬化，及慢性肝炎患者），用电化学发光法检测AFP；采用WesternBlot方法和ELISA方法检测高尔基蛋（q73（GP73）。结果GP73的ROC曲线下面积为0．873，当35．76ng／ml为GP73诊断肝细胞癌的cut．off值时，GP73检测肝细胞癌的敏感性和特异性分别为79．6％和85．9％。AFP阳性的肝癌组23．4％（11／47）GP73阴性，如果单用GP73检测，会漏诊23．4％。AFP阴性同时GP73阴性占（6／93）6．4％，联合检测AFP、GP73，肝癌漏诊率降低至6．4％。肝硬化组GP73浓度均值大于慢性肝炎及正常人群，但差异无统计学意义。丙型肝炎肝癌组GP73浓度均值高于乙型肝炎及非病毒性肝炎肝癌，差异有统计学意义。结论GP73诊断肝细胞癌的敏感性优于AFP。GP73、AFP联合应用有较好的互补性，可以有效避免可能发生的AFP阴性病例的漏检。GP73可成为鉴别肝硬化、肝癌患者的血清标志物，有一定的早期诊断价值。

Objective To evaluate the value of GP73 in the diagnosis of primary liver cancer, in search of better indicators of liver cancer early diagnosis. Methods A total of 93 cases of liver cancer patients.Control groups a total of 71 cases （including health, cirrhosis, and patients with chronic hepatitis）,Electricity chemiluminescence was applied for the detection of AFP. Westem Blot and ELISA were used to detect the Golgi protein 73 （GP73）. The patient clinical data were collected and, and statistically analyzed. Results GP73 of the area under ROC curve was 0.873 and when GP73 of 35.76 ng / ml was taken as the cut-off value diagnosis of hepatocellular carcinoma （HCC）,the sensitivity and specificity of the GP73 detection of hepatocellular carcinoma （HCC） was 79.6% and 85.9%, respectively.In the alpha-fetoprotein-positive hepatocellular carcinoma group, 23.4% （11/47） of the population of GP73-negative, if a single GP73 was used to detect liver cancer, 23.4% would be be missed. Alpha- fetoprotein-negative GP73-negative accounted for 6.4% （6/93）, the joint detection of AFP and GP73, for liver cancer would decrease the misdiagnosis rate to 6.4 percent. Mean GP73 concentration of cirrhosis population was greater than the chronic hepatitis and the normal population, but with no clear statistical significance. Conclusions The GP73 is better than AFP for the diagnosis of hepatocellular carcinoma in the sensitivity. GP73 and AFP have good complementarity, which makes the joint detection of AFP and GP73 effectively avoid the missing of possibility of AFP-negative cases. GP73 can be used as serum markers to identify cirrhosis and liver cancer patients, also it has the early diagnostic value.