血清GPC3联合AFP检测对肝癌患者诊断与肝功能评估的价值

Study on value of serum Glypican-3 combined with AFP detection in diagnosis and liver function evaluation of patients with liver cancer

目的探讨血清磷酸酯酰肌醇蛋白聚糖-3(GPC3)联合甲胎蛋白(AFP)检测对原发性肝癌(PHC)患者诊断与肝功能的评估价值。方法选择52例PHC患者纳入研究组;同时选择肝硬化患者18例,慢性乙型肝炎患者16例,脂肪肝患者10例及肝血管瘤患者8例纳入病例对照组(52例);选择同期参加体检的健康人52例纳入健康对照组。采用酶联免疫吸附试验检测血清GPC3水平,电化学发光法检测血清AFP水平。结果研究组患者GPC3、AFP水平高于病例对照组和健康对照组,差异有统计学意义(P<0.05);病例对照组GPC3、AFP水平高于健康对照组,差异有统计学意义(P<0.05)。PHC组患者AFP水平与GPC3呈正相关(r=0.579,P<0.05);以血清GPC3≥20ng/mL、AFP≥200ng/mL为诊断阳性值,GPC3诊断PHC的敏感度为65.38%,特异度为92.31%;AFP诊断PHC的敏感度为71.15%,特异度为84.62%;二者结合诊断PHC的敏感度为90.38%,特异度为88.46%。GPC3联合AFP检测诊断敏感度高于单纯GPC3检测及AFP检测(P<0.05)。PHC患者组GPC3阳性患者AST、ALT、PT水平明显高于GPC3阴性患者,ALB水平明显低于GPC3阴性患者,差异有统计学意义(P<0.05)。结论血清GPC3水平与原发性肝癌关系密切,GPC3和AFP联合检测有助于提高诊断敏感度并有助于判断患者肝功能。

Objective To investigate the value of serum Glypican-3（GPC3）combined with alpha-fetoprotein（AFP）in the diagnosis and liver function evaluation of the patients with primary hepatocellular carcinoma（PHC）.Methods Fifty-two cases of PHC were included in the study group,meanwhile 18 cases of liver cirrhosis,16 cases of chronic hepatitis B and 10 cases of fatty liver were selected in the case control group（52 cases）.Contemporaneous 52 healthy subjects undergoing physical examination were included in the healthy control group.The ELISA method was adopted to detect serum GPC3 level and the electrochemiluminescence immunoassay（ECLI）was adopted to detect serum AFP level.Results The levels of GPC3 and AFP in the study group were higher than those in the case control group and healthy control group,the difference was statistically significant（P〈0.05）;the levels of GPC3 and AFP in the case control group were higher than those in the healthy control group,the difference was statistically significant（P〈0.05）;the AFP level in the study group was positively correlated with the GPC3 level（r=0.579,P〈0.05）;with serum GPC3≥20 ng/mL and AFP≥200 ng/mL as the diagnostic positive values,the sensitivity and specificity of GPC3 in the diagnosis of PHC were 65.38% and 92.31% respectively,which of AFP in the diagnosis of PHC were 71.15% and84.62%respectively,and which of GPC3 combined with AFP in the diagnosis of PHC were 90.38% and88.46% respectively.The diagnostic sensitivity of GPC3 combined with AFP detection was higher than that of simple GPC3 detection and AFP detection（P〈0.05）.In the PHC group,the AST,ALT and PT levels of the patients with GPC3 positive were significantly higher than those of the patients with GPC3 negative,and the ALB level was significantly lower than that of the patients with GPC3 negative,the difference was statistically significant（P〈0.05）.Conclusion Serum GPC3 level is closely correlated with PHC,and the combined detection of GPC3 and AFP is helpful to increase the diagnosis sensitivity and judge the liver function of the patients.