血清高尔基体蛋白73在肝细胞肝癌早期诊断中的价值

Value of golgi protein73 in diagnosis of hepatocellular carcinoma

目的探讨血清高尔基体蛋白73(GP73)在肝细胞肝癌(HCC)早期诊断中的价值。方法分别检测57例HCC患者、71例肝硬化患者、82例乙型肝炎病毒(HBV)携带者和60例健康人的血清GP73水平及血清甲胎蛋白(AFP)水平,计算受试者工作特征曲线(ROC)下面积及对HCC诊断的敏感性与特异性。结果 HCC组中血清GP73水平显著高于健康对照组(P<0.05),肝硬化组、HBV携带者组血清GP73水平也有一定程度升高,但明显低于HCC组,差异均有统计学意义(P<0.05)。通过ROC曲线确定诊断HCC的血清GP73的cut-off值为100.18μg/L,在此临界值下GP73诊断HCC的敏感度和特异度分别为86.0%和93.9%;AFP诊断HCC的cut-off值为37.05μg/L,其诊断HCC的敏感度和特异度分别为77.2%和91.5%。二者联合检测HCC的敏感度为91.2%,特异度为92.5%。血清AFP浓度小于400μg/L的21例HCC患者中,有16例患者(76.19%)血清GP73水平高于临界值。结论 GP73高表达于HCC患者的血清中,对HCC诊断具有较好的敏感性与特异性,可作为肝癌早期诊断的血清标志物,与AFP联合检测可有效提高肝癌诊断的敏感度,特别有助于AFP阴性的肝癌患者的诊断。

Objective To explore serum golgi protein73 （GP73） in the diagnosis of hepato- cellular carcinoma（HCC）. Methods Serum GP73 and Alphafeto protein（AFP） were quantita- tively detected in a total of 270 human subjects, including 57 patients with HCC, 71 patients with cirrhosis, 82 hepatitis B virus（HBV） carriers and 60 healthy adults. The receiver operating characteristic curve（ROC）, sensitivity and specificity of GP73 and AFP for HCC patients were calculated. Results The serum level of GP73 in patients with HCC was significantly higher than that in healthy controls （P 〈 0.05）. Although GP73 levels in HBV carriers and patients with cirrhosis were somewhat elevated, they were much lower than those in patients with HCC （P 〈 0.05）. Using 100.18 ptg/L as a cut - off value, the sensitivity and specificity of GP73 for HCC were 86.0 % and 93.9%, compared with 77.2% and 91.5% for AFP using 37.05 μg/L as a cut - off value. The sensitivity and specificity of the combination of GP73 and AFP were 91.2% and 92.5% respectively. Moreover, the GP73 level was elevated in the serum of individuals with HCC who had AFP level less than 400 μg/L（16/21,76.19% ））. Conclusion Higher level of GP73 can be found in the serum of patients with HCC than those without. GP73 maybe a good serum marker of the early diagnosis of HCC. The detection of GP73 combined with AFP can effectively improve the sensitivity of the diagnosis of HCC, and especially contributes to the diagnosis of HCC patients with AFP - negative.