联合检测磷脂酰肌醇蛋白聚糖3与总胆汁酸及γ-谷氨酰转肽酶在原发性肝癌诊断中的应用

Combined detection of GPC3,TBA and GGT in application of diagnosis of primary hepatocellular carcinoma

目的探讨联合检测磷脂酰肌醇蛋白聚糖3(GPC3)与总胆汁酸(TBA)及γ-谷氨酰转肽酶(GGT)在原发性肝癌(PHC)诊断中的临床意义。方法收集2010年5月至2011年1月确诊的肝癌患者45例(PHC组),肝硬化患者43例(肝硬化组),正常对照者30例(正常对照组),采用酶联免疫法分别测出GPC3的浓度,采用循环酶法检测TBA,采用速率法检测GGT。结果 (1)PHC组与其他2组比较,GPC3、TBA、GGT的检测值差异有统计学意义(t=29.197、32.481,12.537、14.957,12.383、14.024,P<0.01)。肝硬化组对照组比较,GPC3、TBA、GGT的检测值差异有统计学意义(P<0.01,t=9.7684;10.991;15.799)。(2)PHC组GPC3和TBA阳性率明显高于肝硬化组和正常对照组,差异有统计学意义(P<0.01);GGT阳性率与肝硬化组和正常对照组差异无统计学意义(P>0.05)。(3)PHC组三者联合检测阳性44例,占97.7%(44/45)。与任何单项比较,差异均有统计学意义(P<0.05)。结论 GPC3与TBA及GGT联合检测明显提高PHC的阳性检出率,对PHC的早期诊断具有重要的临床意义。

Objective To evaluate the clinical significance of combined detection of GPC3, TBA and γ-glutamyl transpeptidase （GGT） in diagnosis of primary hepatoeellular carcinoma （PHC）. Methods Forty-five patients with liver carcinoma, 43 patients with cirrhosis and 30 healthy subjects were enrolled in the study in our hospital from May 2010 to January 2011, and they were divided into PHC group, cirrhosis group and control group. The levels of GPC3, TBA, GGT were detected by enzyme-linked immunosorbent assay, cyclophorase assay, velocity method, respectively. Results （ 1 ） There were significant differences in the levels of GPC3, TBA, GGT between PHC group and the other two groups （ P 〈 0.01 ）. There were significant differences in the levels of GPC3 ,TBA,GGT between cirrhosis group and control group （ P 〈0.01 ）. （2）The positive rates of GPC3 and TBA in PHC group were significantly higher than those in cirrhosis group or control group （ P 〈 0.01 ） , however, there was no significant difference in positive rate of GGT between cirrhosis group and control group （ P 〉 0.05 ）. （ 3 ） The positive rate of combined detection of the three parameters was 97.7% （44/45）, and the positive rate of combined detection was superior to that of any single item detection （ P 〈 0.05 ）. Conclusion The combined detection of GPC3, TBA and GGT can enhance obviously positive rate of PHC, which has important clinical significance in early diagnosis of PHC.