血清标本高尔基体蛋白73定量检测及其临床意义

Quantitative determination of serum Golgi protein 73 and its clinical value

目的探讨定量测定血清高尔基体蛋白73(GP73)的临床意义。方法采用双抗体夹心酶联免疫吸附法(ELISA)测定肝癌治疗前、肝癌介入术后、肝癌切除术后、肝移植术后、肝癌复发、乙肝肝硬化、慢性乙型肝炎、乙肝携带者、慢性丙型肝炎、脂肪肝以及健康体检血清标本中的GP73浓度。结果肝癌治疗前病例组中GP73的ROC曲线下面积为0.983,敏感性和特异性分别为96.8%和93.9%;对比肝癌治疗前,介入术后GP73浓度下降(P<0.001),肝癌切除和肝移植术后GP73浓度下降(P<0.001),肝癌复发伴随GP73浓度升高。与健康体检组比较,GP73浓度在肝硬化病例组中显著升高(P<0.001),但是低于肝癌治疗前病例组中GP73浓度(P<0.001)。在慢性乙型肝炎、乙肝携带者、脂肪肝病例组中均可检测到GP73,但显著低于肝癌治疗前病例组(P<0.001)。GP73浓度与肝癌分期的相关性不明显。6种非肝脏恶性肿瘤标本中GP73浓度显著低于未治疗的肝癌标本(P<0.001)。GP73在丙肝相关肝病的浓度均显著高于乙肝相关肝病(P<0.001)。结论 GP73可作为辅助临床早期诊断肝癌的一种标志物,对肝癌术后的复发及肝硬化的进展也有监测作用。

Objective To study the diagnosis significance of serum Golgi protein 73（GP73） in patients with hepato- cellular carcinoma（HCC）. Methods The double antibody sandwich EL1SA quantitative measurement methods were used for the detection of serum GP73 level in a total of 6 069 subjects, including patients with HCC before surgery, patients with HCC after intervention, hepatectomy, transplantation or recurrence, patients with cirrhosis, patients with chronic hep- atitis B, HBV carriers, patients with chronic hepatitis C, patients with fatty liver and healthy adults. Results The AUROC for GP73 was 0.983, the sensitivity was 96.8% and specificity was 93.9% in patients with HCC before surgery. GP73 lev- els in patients with HCC decreased following intervention, surgical resection or transplantation and increased with tumor recurrence （P 〈 0.001）. In contrast, the median value of GP73 in patients with cirrhosis was significantly higher than that of healthy subjects （P 〈 0.001） but lower than that of HCC subjects （P 〈 0.001）. GP73 could be detected in patients with chronic hepatitis B, HBV carriers and patients with fatty liver, which was significantly lower than that of HCC subjects （P 〈 0.001）. The correlation between GP73 level and staging of HCC was not remarkable. The level of GP73 was signifi- cantly higher in HCC than the other kinds of tumors（P 〈 0.001）. GP73 levels in hepatitis C patients were significantly higher than those of patients with hepatitis B （P 〈 0.001）. Conclusion GP73 is an accurate serum marker for the early detection of HCC and it increases after surgery and may be also used in the surveillance of cirrhosis.