检测高尔基体蛋白73应用于原发性肝癌患者危险性的临床意义

Clinical significance of detecting Golgi protein 73 in prognosis of primary liver cancer

目的探讨检测高尔基体蛋白73（GP73）应用于原发性肝癌患者的危险性判断及评估预后的临床意义。方法回顾分析我院2009年1月1日至2011年7月1日期间原发性肝癌患者的病例资料，并随访。根据患者预后分为转移组和未转移组，通过组问单因素比较及多因素Lo—gistic回归分析等方法评价各因素与患者不良预后的相关性。结果共纳入调查84例患者，平均年龄（49．14±9．69）岁，与未转移组相比，转移组的男性所占比、饮酒史所占比、吸烟史所占比、家族遗传史所占比、乙肝患者所占比、甲胎蛋白、高尔基体蛋白73与患者不良预后有显著相关性。将该指标引入多因素Logistic回归分析，得出最佳线性方程由抽烟史所占比、饮酒史所占比、乙肝所占比、甲胎蛋白、高尔基体蛋白73构成。再将上述相关危险因素行ROC曲线检验并计算曲线下面积，判别危险因素的检验效能，纳入高尔基体蛋白73后曲线下面积为0．912，较未纳入时显著增加，且曲线的Youden指数较未纳入时显著升高。结论高尔基体蛋白73升高将增加原发性肝癌患者不良预后的风险，将该指标纳入原发性肝癌的评测体系可进一步增强评估该病患者高危风险的能力。

Objective To explore significance Of Golgi protein （GP）73 detection evaluating risk and prognosis in primary liver cancer patients. Methods The clinical data of patients with primary liver cancer in our hospital from January 1 st, 2009 to July 1 st ,2011 were reviewed and followed up. According to the prognosis, patients were divided into metastatic group and non-metastatic group. The single factor com- parison by groups, multivariate logistic regression analysis, and other methods were applied to evaluate the correlation between these factors and the prognosis. Results The average age of 84 patients investigated was 49.14 ＋ 9.69 years old. Compared with non-metastasis group, there was significant correlation between poor prognosis and the following factors in metastasis group：male, drinking history, smoking history, family history, HBV positive, AFP, and GP73. These indicators were introduced to multi-factor logistic regression analysis, and the optimal linear equation was composed of drinking history, smoking history, HBV positive, AFP, and GP73. These risk factors were then tested by ROC curve, and the area under the curve was calcu- lated to judge their test performance. When GP73 was included, the area under the curve was significantly increased to 0. 912, and the Youden index was significantly increased. Conclusion Elevated GP73 will increase the risk of a poor prognosis of patients with primary liver cancer. Including this indicator into the evaluation system of primary liver cancer can further improve the risk assessment.