GP73和HSP90α在低浓度甲胎蛋白原发性肝癌诊断中的应用价值

Values of GP73 and HSP90αin the diagnosis of primary hepatic carcinoma with low concentration of alpha-fetoprotein

目的探讨高尔基体蛋白73(GP73)和热休克蛋白90α(HSP90α)在低浓度甲胎蛋白(AFP)原发性肝癌(PHC)诊断中的应用价值。方法收集150例血清,其中AFP低浓度PHC患者50例,肝硬化患者30例,肝炎患者30例,健康对照者40例。采用ELISA方法检测各组人群血清GP73和HSP90α含量,比较各组间GP73和HSP90α水平。结果AFP低浓度PHC患者中,血清GP73和HSP90α含量以及阳性检出率高于肝硬化、肝炎、健康对照者,差异有统计学意义(P均<0.01)。有淋巴结转移和门脉侵犯的AFP低浓度PHC患者血清GP73和HSP90α含量高于无淋巴结转移和门脉侵犯的PHC患者,差异有统计学意义(P<0.05)。单独检测中血清GP73和HSP90α灵敏度分别为78.0%和84.0%,特异度分别为77.0%和95.0%,准确度分别为77.3%和91.3%。联合检测中GP73或HSP90α任一阳性诊断AFP低浓度PHC的灵敏度最高,达到94.0%。而GP73和HSP90α同时阳性诊断AFP低浓度PHC的特异度最高,达到96.0%。结论血清GP73和HSP90α单独用于诊断AFP低浓度PHC的灵敏度和特异度都较高,可用于辅助诊断AFP低浓度PHC。两者联合检测具有更高的灵敏度,可提高对AFP低浓度PHC诊断的准确率,具有较高的临床应用价值。

Objective To explore the value of golgi protein 73(GP73)and heat shock protein 90α(HSP90α)in the diagnosis of primary hepatic cancer(PHC)with low levels of alpha-fetoprotein(AFP).Methods ELISA was used to analyze the serum levels of GP73 and HSP90αin 50 cases of PHC with low levels of AFP,30 cases of liver cirrhosis,30 cases of hepatitis,40 cases of healthy controls.Serum levels of GP73 and HSP90αamong groups were compared.Results The serum levels and positive detection rates of GP73 and HSP90αwere significantly higher in PHC group with low levels of AFP than those in the group of liver cirrhosis,hepatitis and healthy controls,and the difference was statistically significant(P<0.01).Serum levels of GP73 and HSP90αin PHC patients with low levels of AFP with lymph node metastasis and portal vein invasion were significantly higher than those in PHC patients without lymph node metastasis and portal vein invasion,and the difference was statistically significant(P<0.05).Sensitivity,specificity and accuracy rates in the diagnosis of PHC with low levels of AFP by GP73 alone were 78.0%,77.0%,77.3%respectively,while those via HSP90αalone were 84.0%,95.0%and 91.3%correspondingly.In the combined detection,the highest sensitivity of GP73 or HSP90αpositive diagnosis was 94.0%and the highest specificity of GP73 and HSP90αpositive diagnosis was 96.0%.Conclusion Both Serum levels of GP73 and HSP90αcan be used as effective tumor biomarkers in the diagnosis of PHC with low levels of AFP and their combination significantly improves diagnostic accuracy with a higher sensitivity.