早期原发性肝癌患者谷氨酰转肽酶、高尔基体糖蛋白及甲胎蛋白变化的临床研究

Clinical study on changes of gamma-glutamyl transpeptidase, Golgi glycoprotein, alpha fetoprotein in patients with early primary liver cancer

目的探讨谷氨酰转肽酶（GGT）、高尔基体糖蛋白（GP73）、甲胎蛋白（AFP）联合诊断早期原发性肝癌的价值,为临床相关诊断提供参考.方法选取本院于2015年11月至2017年11月收治的原发性肝癌患者218例,另选取同期收治的152例肝硬化患者,140例健康体检者作为对照组.对比3组受试者GGT、GP73、AFP含量及各指标特异度及灵敏性,并进行ROC曲线分析.结果原发性肝癌组血清GGT、GP73、AFP含量均高于肝硬化组及对照组,且肝硬化组血清GGT、GP73、AFP含量均高于对照组,差异均有统计学意义（P〈0.05）;ROC曲线图显示,AFP曲线下面积0.84、GGT曲线下面积0.77、GP73曲线下面积0.72,AFP、GGT、GP73三者联合诊断曲线下面积0.94.3项联合诊断的灵敏度及特异度高于AFP、GGT、GP73单项诊断.结论早期原发性肝癌患者血清AFP、GGT、GP73含量升高,且3项指标联合诊断具有较高的灵敏度和特异度,值得临床借鉴.

Objective To investigate the value of combination of gamma-glutamyl transpeptidase （GGT）, Golgi glycoprotein （GP73）, and alpha fetoprotein （AFP） in the diagnosis of early primary liver cancer, and to provide reference for clinical diagnosis. Methods 218 patients with primary liver cancer and 152 patients with liver cirrhosis who were treated in our hospital from November 2015 to November 2017 were selected, and 140 healthy subjects were selected as the control group. The contents of GGT, GP73, AFP, and the specifcity and sensitivity of each index were compared among the 3 groups, and the ROC curve was analyzed. Results The serum contents of GGT, GP73, and AFP in primary liver cancer group were higher than those in liver cirrhosis group and control group, and the serum contents of GGT, GP73, and AFP in liver cirrhosis group were higher than those in the control group, with statistically signifcant differences （P〈0.05）. ROC curve showed that the area under the curve of AFP was 0.84, the AUC of GGT was 0.77, the AUC of GP73 was 0.72, the AUC of AFP, GGT, GP73 three combined diagnosis was 0.94. The sensitivity and specifcity of three combined diagnosis were higher than those of each item. Conclusion The serum levels of AFP, GGT, and GP73 in patients with early primary liver cancer are increased, and the combined diagnosis of the 3 indicators has higher sensitivity and specifcity, which is worthy of clinical reference.