血清标志物GP73在原发性肝癌诊断中的作用

Research on the diagnostic role of serological marker GP73 in primary hepatic carcinoma

目的分析GP73在原发性肝癌诊断中的作用，探讨血清GP73和AFP联合检测对原发性肝癌诊断的意义。方法采用酶联免疫吸附试验（ELISA）定量检测60例体检正常者（正常对照）、178例慢性肝炎或肝硬化（CH／LC）患者和194例原发性肝癌（PHC）患者血清中的GP73，同时采用电化学发光法检测血清中AFP的水平。结果经Kruskal—Wallis检验正常对照组、CH／LC组和PHC组GP73表达水平的差异有统计学意义（P〈0．001）且PHC组的GP73水平明显高于CH／LC组（P〈0．001）。以ROC曲线确诊PHC的GP73临界值为190．7ng／ml，AFP的临界值为35．2ng／ml，单项检测时，GP73的敏感度和特异度分别为66．5％和86．6％，AFP的敏感度与特异度分别为58．8％和83．7％。GP73和AFP联合检测时敏感度与特异度分别为85．6％和81．5％。结论GP73对PHC的诊断有较好的敏感度和特异性，血清GP73联合AFP检测能够有效地提高PHC的诊断效率。

Objective To explore the diagnostic value of GP73 in the patient of primary hepatic carcinoma,to discuss the joint roles of serum GP73 and AFP in the diagnosis of PHC. Methods ELISA was used to detect the serum level of GP73 and chemiluminescence immunoassay system was used to detect the serum level of AFP. A total of 432 serum samples were included, with 60 from health donors（Normal） , 178 from either chronic hepatitis or cirrhosis（CH/CL）, and 194 from PHC patients. Results Kruskal- Wallis test showed that the serum levels of GP73 had significant differences between 3 groups （ P 〈 0.01 ） , and the serum levels of GP73 in PHC were higher than CH/CL or Normal. The critical values for GP73 and AFP was determined to be 190.7 ng/ml, and 35.2 ng/ml through the ROC curves, under the critical value the sensitivity of GP73 and AFP were 66.5% and 58.8% , and the specificity of GP73 and AFP were 86.6% and 83.7% , respectively. Jiont detection could increase the sensitivity up to 85.6% , and achieve the high specificity of 81.5%. Conclusions GP73 has very good sensitivity and specificity. The joint detection of GP73 and AFP could improve PHC diagnostic performance.