GPC3与PIVKA-Ⅱ联合诊断提升肝细胞癌诊断准确度

The Combination of Plasma Glypican-3 and PIVKA-ⅡImproves Diagnostic Efficiency in Hepatocellular Carcinoma

目的:探讨GPC3、PIVKA-Ⅱ、AFU和AFP联合诊断肝细胞癌的效能。方法:从湖北医药学院附属太和医院共收集176例血清标本,其中肝细胞癌患者95例,肝硬化患者49例,健康体检标本32例,采用ELISA法检测GPC3的表达,电化学发光法检测AFP与PIVKA-Ⅱ的表达,全自动生化分析仪检测AFU的表达,采用ROC曲线分析各标志物单独与联合诊断肝细胞癌的敏感度与特异度。结果:AFP、GPC3、PIVKA-Ⅱ和AFU在肝细胞癌患者中的水平均显著高于肝硬化组与健康对照组(P<0.05),ROC曲线下面积分别为0.767、0.817、0.872和0.708,GPC3联合PIVKA-Ⅱ的诊断准确度最高,其敏感度与特异度分别为87.4%、79.0%,四种标志物同时检测可将敏感度提高至95.8%,但特异度降为67.9%。结论:血清GPC3联合PIVKA-Ⅱ检测可以提高肝细胞癌的诊断准确度。

Objective To explore the diagnostic efficiency of glypican-3(GPC3), protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ), α-fucosidase(AFU) and α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients. Methods A total of 176 serum samples were collected from Taihe Hospital affiliated to Hubei University of Medicine, including 95 patients with HCC, 49 patients with liver cirrhosis, and 32 healthy specimens. The expression of GPC3 was detected by ELISA method, and AFP and PIVKA-II were detected by electrochemiluminescence method. An automatic biochemical analyzer was used to detect the expression of AFU. The ROC curve analysis was used to analyze the sensitivity and specificity of each marker alone and in combination in the diagnosis of HCC. Results The levels of AFP, GPC3, PIVKA-Ⅱ and AFU in HCC patients were significantly higher than those in cirrhosis group and healthy control group(P<0.05), with ROCs of 0.767, 0.817, 0.872 and 0.708 respectively. The diagnostic accuracy of GPC3 combined with PIVKA-Ⅱ was the highest, with the sensitivity and specificity 87.4% and 79.0% respectively. The sensitivity was increased to 95.8% by simultaneous detection of four markers, but the specificity was reduced to 67.9%. Conclusion The detection of serum GPC3 combined with PIVKA-Ⅱ can improve the diagnostic accuracy of hepatocellular carcinoma.