AFP-L3、GP73、GPC3联合检测在原发性肝癌诊断中的应用价值

Application value of combined detection of AFP-L3,GP73 and GPC3 in diagnosing primary hepatic cancer

目的探讨3项血清肿瘤标志物甲胎蛋白异质体3(AFP-L3)、高尔基体蛋白73(GP73)和磷脂酰肌醇蛋白聚糖-3(GPC-3)联合检测在原发性肝癌(PHC)诊断中的临床价值。方法采用酶联免疫吸附测定法(ELISA)检测PHC组34例,肝硬化组20例,慢性乙型肝炎组20例,其他肿瘤组37例血清AFP-L3、GP73、GPC-3的表达水平,同期选择20例门诊健康体检者作为对照组。对各指标表达情况进行比较和分析。结果 PHC组AFP-L3、GP73、GPC-3表达水平明显高于对照组和其他肿瘤组,差异有统计学意义(P<0.05);3项标志物单项检测PHC的ROC曲线下面积分别为0.909、0.832、0.817;两两联合检测ROC曲线下面积分别为0.935、0.945、0.912,3项指标联合检测PHC的ROC曲线下面积可高达0.960。结论联合检测AFP-L3、GP73和GPC-3可提高PHC的检出率,对PHC的早期诊断具有重要的临床意义。

Objective To study the clinical value of the combination detection of serum tumor markers alpha fetal protein hetero-geneity-L3（AFP-L3） ,Golgi protein 73（GP73） and phosphatidylinositol proteoglycan-3（GPC-3） in the diagnosis of primary hepatic cancer .Methods The serum AFP-L3 ,GP73 and GPC-3 levels were measured in 34 patients with primary hepatic cancer （PHC） ,20 patients with liver cirrhosis ,20 patients with chronic hepatitis B ,37 patients with other tumors by the enzyme linked immunosor-bent assay（ELISA） .Meanwhile ,20 individuals with healthy physical examination were selected as the control group .The expression situation of various indexes were compared and analyzed .Results The expression levels of AFP-L3 ,GP73 and GPC-3 in the PHC group were significantly higher than those in the control group and the other tumors groups ,difference was statistically significant （P＆lt;0 .05） .The areas under the receiver operating characteristic （ROC） curve of PHC in the single item detection of 3 markers were 0 .909 ,0 .832 and 0 .817 respectively .The areas of the ROC curve in the combination examinations of two items were 0 .935 , 0 .945 and 0 .912 respectively .The area of the ROC curve in the 3-item combined detection of PHC could be up to 0 .960 .Conclusion The combined detection of AFP-L3 ,GP73 and GPC-3 can increase the detective rate of PHC and has important clinical significance to early diagnosis of PHC .