血清甲胎蛋白和高尔基体蛋白73在不同肝脏肿瘤中的表达及临床价值研究

The expression and clinical significance of serum alpha fetoprotein and Golgi protein 73 in different liver tumors

目的探讨血清甲胎蛋白(AFP)和高尔基体蛋白73 (Golgi protein 73,GP73)在不同肝脏肿瘤中的表达水平及临床价值。方法选取2015年10月至2017年10月在宁波市第一和第二医院住院的肝肿瘤患者545例,其中肝细胞癌(HCC)440例、肝转移性癌28例、胆管癌24例和肝良性占位53例。采用微粒子酶免疫分析技术和酶联免疫吸附试验对患者血清AFP和GP73进行检测,对检测结果进行统计学分析。结果 234例肝细胞癌未治疗组的AFP水平高于肝良性占位组、肝转移性癌组和胆管癌组(均P<0.05),而肝良性占位组的GP73水平显著低于肝转移性癌组、胆管癌组和肝细胞癌未治疗组(均P<0.05);血清AFP和GP73从肝良性占位、肝转移性癌和胆管癌等疾病中鉴别诊断肝细胞癌的ROC曲线下面积(AUC)分别为0.87(0.84~0.91)、0.65(0.59~0.71),前者优于后者(P<0.05)。肝细胞癌复发组血清GP73和AFP水平均高于手术或消融治疗组(P<0.05),与肝细胞癌未治疗组、经导和这动脉化疗栓塞术(TACE)治疗组的差异无统计学意义(均P>0.05);手术或消融治疗组AFP和GP73水平均低于未治疗组、复发组和TACE治疗组(均P<0.05)。结论相较于血清GP73,AFP对肝细胞癌有更好的鉴别诊断价值,但两者均可用于监测肝细胞癌的复发和预后。

Objective To understand the expression level and clinical significance of serum alpha fetoprotein(AFP)and Golgi protein 73(73,GP73)in different liver tumors.Methods From October 2015 to October 2017,545 patients with liver tumor in Ningbo hospitals were enrolled,including 440 cases of hepatocellular carcinoma(HCC),28 cases of liver metastatic carcinoma,24 cases of bile duct cancer and 53 cases of benign liver tumor.The serum AFP and GP73 were determined by microparticle enzyme immunoassay and enzyme linked immunosorbent assay(ELISA),and the results were statistically analyzed.Results The AFP level of 234 cases with HCC was significantly higher than that of cases in other groups(P<0.05),while the GP73 level of cases with benign liver tumor was significantly lower than others(P<0.05).The area under ROC curve(AUC)of serum AFP and GP73 in the differential diagnosis of HCC from benign liver tumor,liver metastatic carcinoma and bile duct cancer were 0.87(0.84-0.91),0.65(0.59-0.71),and the former was better than the latter(P<0.05).The serum GP73 and AFP levels in patients with recurrent HCC,untreated HCC and TACE therapy were significantly higher than that of those with surgery or ablation therapy(P<0.05),while there were no significant differences in serum levels of GP73 and AFP among patients with recurrent HCC,untreated HCC and treated with TAC(P>0.05).Conclusions Compared with serum GP73,AFP may be more helpful in the differential diagnosis of HCC,while both can be used to monitor the recurrence and prognosis of HCC.