GPC3对原发性肝癌的诊断价值

Study on diagnostic significance of GPC3 in the patients with primary hepatocellular carcinoma

目的探讨磷脂酰肌醇蛋白聚糖3（glypican-3，GPC3）对原发性肝癌的诊断意义，尤其是对AFP阴性及肿块较小的肝癌患者的诊断价值。方法收集120例肝癌、32例肝硬化病人，通过ELISA法检测标本GPC3值，电化学发光法检测标本AFP值，肝癌组根据肿块大小分为4组（〈3cm、3～5cm、5～10cm和〉10cm）进行结果分析。结果（1）肝癌组GPC3值为（22．014±36．930）ng／mL，肝硬化组GPC3值为（8．590±8．171）ng／mL，两组比较差异有显著性意义（P〈0．01）。（2）肝癌肿块〈3cm组GPC3和AFP的阳性率分别为86．67％和71．43％，二者之间差异无显著性意义（P〉0．05）；肝癌肿块3-5cm、5～10cm、〉10cm组的GPC3的阳性率低于AFP，二者间差异也无显著性意义（P〉0．05）。（3）AFP阴性的肝癌患者中GPC3的阳性率为75％。结论GPC3作为新兴的肿瘤标志物，可能对AFP阴性和小肿块肝癌患者的诊断价值较大，GPC3与AFP联合检测更有利于肝癌的早期诊断。

Objective To evaluate the diagnostic value of GPC3 for patients with primary hepatocellular carcinoma, especially when AFP was negative or swelling was smaller. Methods Serum GPC3 and AFP were measured by ELISA and the electrochemical luminescence method in 120 patients with primary hepatocellular carcinoma, 32 patients with hepatic cirrhosis. The results were divided into groups according to the size of swelling（ 〈3 cm,3 -5 cm,5 - 10 cm 和 〉 10 cm ）. Results （ 1 ） The value of GPC3 in hepatocellular carcinoma group was （22. 014 ±36. 930） ng/mL, and the value of GPC3 in hepatic cirrhosis was （ 8. 590 ±8. 171 ） ng/mL. The difference was significant between two groups （ P 〈 0.01 ）. （ 2 ） The positive rates of GPC3 and AFP were 86.67% and 71.43% in swelling size 〈 3 cm group, and the difference was not significant （P 〉 0. 05 ）. The positive rates of GPC3 in the other groups （swelling size 3 - 5 cm, 5 - 10 cm, 〉 10 cm） were lower than AFP,and the difference was not signifieant（P 〉0.05）. （3） The positive rate of GPC3 in case of negative AFP was 75 %. Conclusion As a new tumor marker in primary hepatocellular carcinoma, GPC3 perhaps has higher diagnosis value in case of negative AFP and smaller swelling size. GPC3 in combination with AFP can improve the early stage detection of HCC.