血清GP73联合AFP、CEA、CA199、GGT检测在PHC早期筛查的应用价值

The significance of combined detection of serum Golgi protein 73,AFP,CEA,CA199 and GGT in the early diagnosis of primary hepatic carcinoma

目的探讨血清高尔基体糖蛋白73(GP73)联合甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、γ-谷氨酰转移酶(GGT)对早期筛查原发性肝癌的临床应用价值。方法收集肝癌实验组患者53例、其他恶性肿瘤对照组患者46例和健康人对照组20例血清,采用酶联免疫吸附试验(ELISA)定量检测法测定血清GP73浓度;化学发光免疫分析仪测定血清AFP、CEA、CA199水平;7600生化分析仪测定血清GGT水平。结果肝癌实验组患者血清GP73水平显著高于其他恶性肿瘤对照组和健康对照组(P<0.05)。ROC曲线分析显示,GP73诊断肝癌的灵敏度(86.8%)明显优于AFP(54.7%)(P<0.01),而特异性较AFP差(P<0.01)。在24例血清AFP呈低浓度的原发性肝癌患者中,血清GP73对肝癌的阳性检出率为75.0%,远高于AFP(P<0.01)。血清GP73联合AFP、CEA、CA199、GGT检测可显著提高肝癌诊断灵敏度,达98.1%。结论血清GP73和AFP、CEA、CA199、GGT联合检测可显著提高肝癌的检出率,对原发性肝癌的早期筛查和诊断具有临床意义。

Objective To study the value of combined detection of serum Golgi protein 73（GP73）, alpha fetoprotein（AFP）,carcino-embryonic antigen（CEA）, carbohydrate atigen 199（CA199） and gamma-glutamyl transferase（GGT） in the early diagnosis of primary hepatic carcinoma（PHC）. Methods The serum levels of GP73, AFP, CEA, CA199 and GGT were measured in 53 cases of PHC, 46 cases of other malignant tumor diseases and 20 cases of healthy persons. GP73 were measured by Enzyme-linked immunosorbent assay（ELISA）. AFP, CEA and CA199 were measured by chemiluminescence immunoassay analyzer and GGT was measured by biochemical analyzer 7600. Results The serum GP73 level in the PHC experimental group was significantly higher than those of other malignant tumor diseases control group and healthy control group（P〈0.05）. ROC curve analysis showed that GP73 had a better sensitivity（86.8%） compared to that of AFP（54.7%）（P〈0.01） while the specificity of GP73 is lower than that of AFP（P〈0.01）. In 24 cases of PHC with AFP level less than the critical value of 400 ng/ml, 75.0% of the cases were positive for the serum GP73 detection; GP73 had a better sensitivity compared to AFP（P〈0.01）. Diagnostic sensitivity（98.1%） was obviously increased by the use of the combined detection of GP73, AFP, CEA, CA199 and GGT. Conclusion Combined detection of serum GP73, AFP, CEA, CA199 and GGT is highly significant for the early diagnosis of PHC.