血清AFP-L3与GP73检测对AFP低浓度肝癌的诊断价值

Value of detection of serum AFP-L3 and GP73 in diagnosis of hepatocellular carcinoma cases with low concentration AFP

目的探讨血清甲胎蛋白异质体(AFP-L3)、高尔基体蛋白73(GP73)检测对甲胎蛋白(AFP)低浓度原发性肝癌(PHC)的诊断价值。方法对42例PHC患者(PHC组)、54例肝脏良性疾病患者(良性组)及40例体检人员(对照组)进行血清GP73、AFP-L3(%)水平测定,比较各组血清GP73、AFP-L3(%)水平和阳性检出率,并比较GP73、AFP-L3(%)单独检测和联合检测对AFP低浓度PHC的诊断价值。结果 PHC组血清GP73、AFP-L3(%)水平高于良性组(P=0.000)和对照组(P=0.000),良性组血清GP73高于对照组(P=0.000),良性组和对照组血清AFP-L3(%)水平比较差异无统计学意义(P=0.526);PHC组GP73、AFP-L3(%)阳性检出率高于良性组(P=0.000)和对照组(P=0.000),良性组和对照组比较差异均无统计学意义(P=0.130、0.079);GP73检测AFP低浓度肝癌的敏感性、特异性均高于AFP-L3(%),两项指标联合检测可进一步提高检测的敏感性和特异性。结论血清GP73、AFP-L3(%)水平检测均可用于AFP低浓度PHC的辅助诊断,GP73诊断效能更优,二者联合应用可提高诊断的敏感性和特异性。

Objective To investigate the values of detection of serum alpha fetoprotein（AFP-L3）and Golgi protein 73（GP73）in diagnosis of primary hepatocellular carcinoma（PHC） cases with low concentration of alpha fetoprotein（AFP）.Methods The serum GP73 and AFP-L3 levels in 42 patients with PHC（PHC group）, 54 patients with benign liver disease（benign group） and 40 volunteers（control group） were determined, the levels and positive rates of serum GP73 and AFP-L3 were caompared between the two groups,the diagnostic values of combined detection and single detection of GP73, AFP-L3 PHcases with low concentration AFP. Results The level of serum GP73 and AFP-L3 of PHC group was higher than that ofbenign group（P =0.000） and the control group（P =0.000）, the level of the serum GP73 of benign group was higher than that ofcontrol group（P =0.000） without significant difference in the serum AFP-L3 levels between the two groups（P =0. 526）; Thepositive detection rate of GP73, AFP-L3 in PHC group was higher than that of benign group（P =0.000） and the control group（P =0.000）without statistical significant difference between the two group（P =0.130, 0.079）; The sensitivity and specificity fordetection of GP73 in PHC cases with low concentration of AFP were higher than that for detection of AFP- L3 and thesensitivity and the specificity could be further improved by combined detection of the two indexes. Conclusion The detectionof serum GP73 and AFP- L3（%） levels can be used for diagnosis of PHC cases with low concentration of AFP and thecombined detection of the two indexes can improve the diagnostic sensitivity and specificity.