三种血清标志物联合检测对肝细胞肝癌的诊断价值研究

Study on the diagnostic value of three serum markers combined for hepatocellular carcinoma

目的:分析肝细胞肝癌患者血清中磷脂酰肌醇蛋白聚糖3(GPC3)、热休克蛋白70(Hsp70)及甲胎蛋白(AFP)单独或联合检测在肝细胞肝癌诊断中的临床应用价值。方法:选取2020年1月至2021年8月在我院肝病科就诊的113例肝细胞肝癌患者与165例慢性乙型肝炎患者为研究对象,并纳入同期在院进行体检的188例健康人群为对照组。以酶联免疫吸附法测定研究对象血清GPC3和Hsp70水平;使用罗氏cobas 8000电化学发光系统测定血清AFP水平。结果:肝细胞肝癌与慢性乙型肝炎患者血清GPC3、Hsp70及AFP水平均高于健康对照组(P<0.05)。三种血清标志物联合检测时诊断肝细胞肝癌的约登指数最大,ROC曲线下面积为0.896(0.783-0.963),其诊断价值最高。结论:组合血清GPC3、Hsp70及AFP检测能提高肝细胞肝癌的诊断准确性,弥补单项标志物检测的不足,提升诊断价值。

Objective:To explore the value of combined detection of glypican3(GPC3),heat-shock protein 70(Hsp70),and alpha-fetoprotein(AFP)in the diagnosis of hepatocellular carcinoma.Methods:A total of 278 hepatocellular carcinoma patients were selected as the study subjects from January 2020 to July 2021,and 188 healthy subjects during the same period were selected as the control group.The serum levels of alpha-fetoprotein were determined by Roche cobas 8000 analysis system.The serum levels of GPC3 and Hsp70 were determined by enzyme-linked immunosorbent assay.ROC curve was used to analyze the diagnostic efficacy of GPC3 and Hsp70.Results:The serum levels of GPC3,Hsp70 and AFP in patients with hepatocellular carcinoma and chronic hepatitis B were significantly higher than healthy subjects(P<0.05).The combined detection of GPC3,Hsp70 and AFP has the highest Youden index in diagnosing hepatocellular carcinoma,which has the highest diagnostic value[AUC=0.896(0.783~0.963)].Conclusion:The combined detection of serum GPC3,Hsp70 and AFP could increase the diagnostic coincidence rate of hepatocellular carcinoma,and enhance the diagnostic value.