AFP-L3与GP73在原发性肝癌中的诊断价值

Role of AFP-L3 and GP73 in diagnosis of primary hepatic carcinoma

目的探讨血清肿瘤标志物甲胎蛋白异质体(AFP-L3)和高尔基体蛋白73(GP73)单独和联合检测在原发性肝癌(PHC)诊断中的临床意义。方法采用酶联免疫吸附测定法(ELISA)进行检测180例患者(80例PHC患者、50例肝硬化患者和50例健康体检者)血清中AFP-L3和GP73的浓度,并比较各组水平差异,运用受试者工作曲线(recover operation characteristic,ROC)确定AFP-L3和GP73浓度诊断PHC的最佳临界值,分析评价AFP-L3和GP73单独检测及2种方法联合检测在PHC中的诊断价值。结果 PHC患者、肝硬化患者、正常对照组的血清AFP-L3浓度分别为(65.234±21.315)ng/ml、(18.614±20.655)ng/ml、(13.209±14.560)ng/ml,PHC组AFPL3水平显著高于肝硬化组及正常组(P<0.001);肝硬化组与正常组的AFP-L3水平比较差异无统计学意义(P=0.134)。通过血清中AFP-L3水平绘制诊断PHC的ROC曲线,AFP-L3诊断PHC的最佳临界值:≥36.076 ng/ml,其诊断敏感性和特异性分别为75.00%、94.00%。PHC组患者、肝硬化组患者、正常对照组的血清GP73浓度分别为(0.431±0.180)IU/ml、(0.228±0.047)IU/ml、(0.213±0.034)IU/ml,PHC组GP73水平明显高于肝硬化组及正常组(P<0.001);而GP73水平在肝硬化组与正常组比较中差异无统计学意义(P=0.069)。通过血清GP73水平绘制诊断PHC的ROC曲线,GP73诊断PHC的最佳临界值:≥0.298 IU/ml,其诊断敏感性和特异性分别为80.00%和96.00%;联合检测AFP-L3和GP7诊断PHC的敏感性为92.50%,特异性为90.00%。结论AFP-L3和GP73是诊断PHC良好的血清肿瘤标志物,均有较高特异性,但敏感度不理想。AFP-L3与GP73联合检测,可提高PHC诊断的敏感性和特异性,对PHC的早期诊断具有积极的意义。

Objective To explore the clinical significance of serum tumor maker lens culinaris agglutinin-reactive et-feto- protein（ AFP-L3 ） and Golgi protein-73 （GP73） single or combined detection in the diagnosis of primary hepatic carcino- ma（PHC）. Methods The serum levels of AFP-L3 and GP73 in 80 patients with PHC, in 50 patients with cirrhosis of liver and in 50 healthy cases was detected by the enzyme-link immunosorbent assay （ELISA）, and were compared among difference groups, and the clinical diagnosis value of AFP-L3 and GP73 in PHC was evaluated. Results The levels of serum AFP-L3 in patients with PHC, cirrhosis and healthy group ： （65. 234± 21. 315）ng/ml, （18. 614 ± 20.655）ng/ml and （ 13. 209 ± 14.560）ng/ml, respectively. The serum AFP-L3 in patients with PHC were higher than that in the cirrhosis of liver group and in the healthy cases group（P 〈 0. 001 ）. Taking AFP-L3 level≥ 36. 076 ng/ml as diagnostic criteria, the sensitivity of AFP-L3 level in PHC diagnosis was 75.00% and the specificity was 94.00%. The levels of serum GP73 in the patients with PHC, patients with cirrhosis of liver and healthy group were （0.431 ± 0.180）IU/ml, （0. 228 ± 0. 047） IU/ml and （0. 213 ± 0. 034）IU/ml,respectively. The serum GP73 in patients with PHC were higher than that in the cir- rhosis of liver group and in the healthy cases group（P 〈 0. 001 ）. Taking GP73 level≥0. 298 IU/ml as diagnostic criteria, the sensitivity of GP73 level in PHC diagnosis was 80.00%, the specificity of GP73 level in PHC diagnosis of GP73 level in PHC diagnosis was 96.00%. The combination of AFP-L3 and GP73 was sensitivity of 92.50% and specificity of 90.00%. Conclusion AFP-L3 and GP73 were very effective serum tumor maker in the clinical diagnosis of the PHC. AFP-L3 and GP73 have a higher specificity. AFP-L3 and GP73 combined detection could increase the sensitivity in the PHC clinical diagnosis. AFP-L3 and GP73 combined detection of PHC is useful.