血清高尔基蛋白体73与异常凝血酶原联合检测在肝癌诊断中的应用

Application of Combined Detection of Serum Golgi Protein 73 and Des-Gamma-Carboxy-Prothrombin in Diagnosis of Hepatocellular Carcinoma

目的探讨高尔基体蛋白73(Golgi protein 73,GP73)及异常凝血酶原(des-gamm-carboxy-prothrombin,DCP)用于肝细胞肝癌(hepatocellular carcinoma,HCC)诊断的临床价值。方法采用酶联免疫吸附法分别检测56例HCC患者、34例肝硬化患者以及30例健康体检者血清GP73以及DCP水平。结果 HCC组患者血清GP73含量为(201.9±92.9)μg·L-1,明显高于肝硬化组的(76.4±25.5)μg·L-1以及对照组的(29.9±15.0)μg·L-1(均P<0.01);HCC组患者血清DCP含量为(115.1±36.1)μg·L-1,明显高于肝硬化组的(45.6±16.4)μg·L-1以及对照组的(23.2±11.4)μg·L-1(均P<0.01)。Spearman相关分析发现,HCC患者GP73与DCP含量之间具有一定相关性,r=0.573,P<0.01。血清GP73诊断HCC最佳临界值为128.5μg·L-1,其诊断灵敏度为80.4%,特异性为87.5%,曲线下面积为0.925 8;血清DCP诊断HCC最佳临界值为73.2μg·L-1,其诊断灵敏度为76.8%,特异性为81.3%,曲线下面积为0.885 3。与血清GP73及DCP单项检测相比,二者联合检测能明显提高HCC的诊断灵敏度、特异性、阳性预测值、阴性预测值以及总有效率均明显高于(P<0.05);而二者单项检测各指标之间比较差异均无统计学意义(P>0.05)。结论 HCC患者血清GP73及DCP含量显著增加,并且2个指标的联合检测对HCC的临床诊疗具有重要价值。

Objective To investigate the clinical value of combined detection of serum Golgi protein 73 (GP73)and des-gamma-carboxy-prothrombin (DCP)in the diagnosis of hepatocellular carcinoma (HCC).Methods Serum levels of GP73 and DCP were determined by ELISA in 56 pa-tients with HCC (HCC group),34 patients with liver cirrhosis (cirrhosis group)and 30 healthy subjects (control group).Results The serum levels of GP73 and DCP were,respectively,(201.9± 92.9)μg·L-1 and (115.1 ± 36.1)μg·L-1 in HCC group,(76.4±25.5)μg· L-1 and (45.6 ± 16.4)μg·L-1 in cirrhosis group,and (29.9±15.0)μg·L-1 and (23.2±11.4)μg·L-1 in control group.Compared with cirrhosis group or control group,serum GP73 and DCP levels significantly increased in HCC group(P <0.01).Spearman’s correlation analysis showed a correlation between GP73 and DCP levels in patients with HCC (r=0.573,P <0.01).The cut-off value,sensitivity, specificity and area under curve (AUC)were,respectively,128.5 μg· L-1 ,80.4%,87.5% and 0.925 8 for serum GP73 detection,and 73.2 μg·L-1 ,76.8%,81.3% and 0.885 3 for serum DCP detection.Compared with single detection,combined GP73 and DCP detection significantly in-creased the sensitivity,specificity,negative predictive value,positive predictive value and total ef-ficiency for the diagnosis of HCC(P <0.05).However,no significant differences in these parame-ters were found between single GP73 detection and single DCP detection(P >0.05).Conclusion The serum levels of GP73 and DCP obviously increase in patients with HCC.The combined detec-tion of these two markers has important value in the clinical diagnosis and treatment of HCC.