摘要
目的探讨血清中磷脂酰肌醇蛋白聚糖3(GPC3)和甲胎蛋白异质体(AFP-L3)对低浓度AFP原发性肝细胞癌(PHC)的应用价值。方法收集51例低浓度AFP的PHC患者、52例非肝癌患者和101例健康对照者的血清,分别检测GPC3和AFP-L3,计算敏感度、特异度、准确度和ROC曲线下面积,分析GPC3和AFP-L3与肝癌相关生物学特征的关系。结果低浓度AFP的PHC患者的GPC3和AFP-L3阳性率高于非肝癌患者和健康对照者,差异有统计学意义(P<0.05),而非肝癌组和健康对照组两者无明显差异(P>0.05)。GPC3诊断低浓度AFP PHC患者的敏感度(54.90%)低于AFP-L3(70.59%),差异有统计学意义(P<0.05)。两项联合检测特异度为97.39%,敏感度为86.27%。GPC3和AFP-L3的ROC曲线下面积分别为0.694和0.731。肿瘤直径<5 cm和TMN分期Ⅰ期GPC3和AFP-L3差异无统计学意义(P>0.05)。结论 GPC3和AFP-L3对低浓度AFP PHC患者具有较好的诊断效能,尤其在早期诊断中具有十分重要意义,联合检测能有效避免漏检。
Objective To explore the clinical value of phosphatidylinositol proteoglycan-3( GPC3) and alpha-fetoprotein-L3( AFP-L3) in diagnosing primary liver cancer( PHC) with low level of alphafetoprotein( AFP). Methods GPC3 and AFP-L3 were detected in 51 cases of primary liver cancer with low level AFP,52 cases of liver cirrhosis and chronic hepatitis B,and 101 healthy controls. The sensitivity,specificity,accuracy and area under the ROC curve were counted,and the relationship of GPC3 and AFP-L3 with related biological characteristics of hepatocellular carcinoma was analyzed. Results The positive rate of GPC3 and AFP-L3 were significant higher in primary liver cancer with low level AFP group than the other two groups,with the differences statistically significant( P〈0. 05); while there was no difference between other liver disease groups and healthy control group( P〈0. 05). The sensitivity of GPC3( 54. 90%) was lower in liver cancer group with low level AFP than that of AFP-L3( 70. 59%),with the differences statistically significant( P〈0. 05). The specificity and sensitivity of combined detection of the two parameters were 97. 39% and 86. 27%. Area of ROC curves of GPC3 and AFP-L3 were 0. 694 and 0. 731. There was no statistical significance on the difference of GPC3 and AFP-L3 in tumor with diameter 5 cm or stage I in TMN respectively( P〉0. 05). Conclusion GPC3 and AFP-L3 have very important meaning in the diagnosis for PHC with low level AFP,especially in the early stage; and combined detection of them can avoid missing cases.
出处
《中国卫生检验杂志》
CAS
2017年第20期2986-2988,2991,共4页
Chinese Journal of Health Laboratory Technology