血清GPC3、GP73、AFP-L3和AFP检测对原发性肝癌诊断的价值

Value of GPC3, GP73, AFP-L3 and AFP detection in the diagnosis of primary hepatic carcinoma

目的探讨血清磷脂酰肌醇蛋白多糖-3(glypican-3,GPC3)、高尔基体蛋白73(Golgi protein-73,GP73)、甲胎蛋白异质体AFP-L3以及AFP单独及联合检测在原发性肝癌(primary hepatic carcinoma,PHC)中的诊断价值。方法 GPC3、GP73、AFP-L3检测采用ELISA法,AFP检测采用化学发光法,分别检测原发性肝癌组(43例)、肝硬化组(43例)、慢性肝炎组(43例)、和健康对照组(43例)血清GPC3、GP73、AFP-L3、AFP水平,应用SPSS统计软件对结果进行统计学分析。结果 PHC组GP73、AFP-L3和AFP水平高于其他各组,差异均有显著性(P=0.000)。GPC3、GP73、AFP-L3和AFP的ROC曲线下面积(AUCROC)分别为0.744、0.910、0.903、0.867,灵敏度分别为53.5%、86.0%、81.4%、76.7%,特异度分别为94.6%、93.8%、95.3%、86.0%。系列试验以GP73+AFP-L3为最佳组合,灵敏度和特异度分别为70.0%和99.7%,平行试验以AFP/AFP-L3/GP73为最佳组合,灵敏度特异度分别为99.4%和76.9%。结论 GP73和AFP-L3有望成为新的诊断原发性肝癌的血清标志物。临床应用中,可用GP73+AFP-L3作为诊断PHC的最佳组合,GP73/AFP-L3/AFP作为排除PHC较好的组合。

[ Objective ] To explore the application value of phosphatidylinositol proteoglycan-3（GPC3）, golgi body protein 73 （GP73）, alpha-fetoprotein different plastid （AFP-L3） and AFP single detection and joint detection in the diagnosis of primary liver cancer. [ Methods] GPC3, GP73, AFP-L3 detection using ELISA method, AFP detection using Chmnilumineseenee method, primary liver cancer group（43 cases）, cirrhosis group （43 cases）, chronic hepatitis group （43 eases） and healthy controls （43 cases） serum GPC3, GP73, AFP-L3, AFP level were respectively detected, the SPSS statistical software was used for statistical analysis. [Results] GP73, AFP-L3, AFP level of PHC were higher than other groups, the differences between each groups were statistically significant （P=O.O00）, the AUCROC of GPC3,GP73,AFP-L3,and AFP respectively were 0.744, 0.910, 0.903, 0.867, the sensitivity was 53.5%, 86.0%, 81.4%, 76.7%, specific degrees were 94.6%, 93.8%, 95.3%, 86.0%. GP73＋AFP-L3 was the best combination for series of test, sensitivity and specific degrees were 70.0% and 99.7%, respectively, AFP/AFP-L3/GP73 was the best combination for parallel test, sensitivity and specific degrees were 99.4% and 76.9% ,respectively. [Conclusion] GP73 and AFP-L3 are expected to become the new serological diagnosis markers of PHC. In clinical application, GP73＋AFP-L3 can be used as the best combination for diagnosis of PHC, GP73 / AFP - L3 / AFP was good combi- nation used to eliminate PHC.