BACKGROUND Reliable biomarkers of cirrhosis,hepatocellular carcinoma(HCC),or progression of chronic liver diseases are missing.In this context,Golgi protein-73(GP73)also called Golgi phosphoprotein-2,was originally de...BACKGROUND Reliable biomarkers of cirrhosis,hepatocellular carcinoma(HCC),or progression of chronic liver diseases are missing.In this context,Golgi protein-73(GP73)also called Golgi phosphoprotein-2,was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells.As a result,GP73 expression was found primarily in biliary epithelial cells,with only slight detection in hepatocytes.However,in patients with acute or chronic liver diseases and especially in HCC,the expression of GP73 is significantly up-regulated in hepatocytes.So far,few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression.AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression.METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA(QUANTA Lite®GP73,Inova Diagnostics,Inc.,Research Use Only)in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa,Greece(n=366)and Debrecen,Hungary(n=266).Aspartate aminotransferase(AST)/Platelets(PLT)ratio index(APRI)was also calculated at the relevant time points in all patients.Two hundred and three patients had chronic hepatitis B,183 chronic hepatitis C,198 alcoholic liver disease,28 autoimmune cholestatic liver diseases,15 autoimmune hepatitis,and 5 with other liver-related disorders.The duration of follow-up was 50(57)mo[median(interquartile range)].The development of cirrhosis,liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines.In particular,the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein(AFP)determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients.RESULTS Increased serum levels of GP73(>20 units)were detected at initial evaluation in 277 out of 632 patients(43.8%).GP73-seropositivity correlated at baseline with the presence of cirrhosis(96.4%vs 51.5%,P<0.001),decompensation of cirrhosis(60.3%vs 35.5%,P<0.001),presence of HCC(18.4%vs 7.9%,P<0.001)and advanced HCC stage(52.9%vs 14.8%,P=0.002).GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score[Area under the curve(AUC)(95%CI):0.909(0.885-0.934)vs 0.849(0.813-0.886),P=0.003].Combination of GP73 with APRI improved further the accuracy(AUC:0.925)compared to GP73(AUC:0.909,P=0.005)or APRI alone(AUC:0.849,P<0.001).GP73 levels were significantly higher in HCC patients compared to non-HCC[22.5(29.2)vs 16(20.3)units,P<0.001)and positively associated with BCLC stage[stage 0:13.9(10.8);stage A:17.1(16.8);stage B:19.6(22.3);stage C:32.2(30.8);stage D:45.3(86.6)units,P<0.001]and tumor dimensions[very early:13.9(10.8);intermediate:19.6(18.4);advanced:29.1(33.6)units,P=0.004].However,the discriminative ability for HCC diagnosis was relatively low[AUC(95%CI):0.623(0.570-0.675)].Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline,was prognostic of higher rates of decompensation(P=0.036),HCC development(P=0.08),and liver-related deaths(P<0.001)during follow-up.CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination.In combination with APRI,its diagnostic performance can be further improved.Most importantly,the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and nonviral chronic liver diseases.展开更多
BACKGROUND： Golgi protein 73 （GP73） is a promising bio- marker of hepatocellular carcinoma （HCC）. It decreases after surgical resection, and resumes upon recurrence, indicating a potential indicator for the effec...BACKGROUND： Golgi protein 73 （GP73） is a promising bio- marker of hepatocellular carcinoma （HCC）. It decreases after surgical resection, and resumes upon recurrence, indicating a potential indicator for the effectiveness of the treatment. But changes of GP73 after transcatheter arterial chemoemboliza- tion （TACE） have not been reported so far. This study was to investigate the dynamic changes of GP73 in HCC patients af- ter TACE treatment, and the possible underlying mechanisms in the cell cultures. METHODS： Blood samples were collected from 72 HCC pa- tients, before TACE, at day I and day 30 after TACE. GP73 lev- els were measured by Western blotting. The dynamic changes of GP73 were analyzed and compared with image changes and clinical data. The effects of chemotherapeutic agents （5-FU and pirarubicin） on GP73 expression were tested in three HCC cell lines （HepG2, HCCLM3 and MHCC97H）. RESULTS： The GP73 level was significantly elevated at day 1 and day 30 after TACE in HCC patients compared with that before the procedure （P〈0.05）. There was no statistical differ- ence between the two time points after TACE, nor correlationbetween GP73 levels and dinicopathological features, tumor metastasis, and patient survival. Pirarubicin, not 5-FU, signifi- cantly increased GP73 expression in three cell lines. CONCLUSIONS： Unlike surgical resection which decreases the GP73 level, TACE significantly increased GP73 expression in patients with HCC. No correlations were observed among GP73 levels, tumor characteristics and prognosis of patients with HCC.展开更多
BACKGROUND Microwave ablation(MWA)is an effective treatment option for patients with primary liver cancer.However,it has been reported that the MWA procedure induces a hepatic inflammatory response and injury,which ma...BACKGROUND Microwave ablation(MWA)is an effective treatment option for patients with primary liver cancer.However,it has been reported that the MWA procedure induces a hepatic inflammatory response and injury,which may negatively affect the efficacy of MWA.As such,the discovery of reliable markers to monitor the patient’s response to MWA is needed.Golgi protein 73(GP73)has been shown to be associated with chronic liver disease.To date,the potential value of serum GP73 in the dynamic monitoring during MWA of liver cancer remains unclear.AIM To examine the effects of MWA on the serum levels of GP73 in patients with primary liver cancer.METHODS A total of 150 primary liver cancer patients with a single small lesion(≤3 cm in diameter)were retrospectively enrolled spanning the period between January 2016 and October 2018.All of the patients received MWA for the treatment of primary liver cancer.Serum GP73,alpha-fetoprotein(AFP),and widely used liver biochemical indicators[serum albumin,total bilirubin(TBIL),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)]were compared before MWA and at different time points,including 1,2,and 4 wk following the ablation procedure.RESULTS Complete tumor ablation was achieved in 95.33%of the patients at 1 mo after MWA.The 1-,2-,and 3-year disease-free survival rates were 74.67%,59.33%,and 54.00%,respectively.The serum AFP levels were significantly decreased at 1,2,and 4 wk after MWA;they returned to the normal range at 12 wk after MWA;and they remained stable thereafter during follow-up in those cases without recurrence.In contrast,the serum GP73 levels were significantly increased at 1 and 2 wk after MWA.The serum GP73 levels reached the peak at 2 wk after MWA,started to decline after hepatoprotective treatment with glycyrrhizin and reduced glutathione,and returned to the pretreatment levels at 12 and 24 wk after MWA.Notably,the changes of serum GP73 in response to MWA were similar to those of TBIL,ALT,and AST.CONCLUSION Serum GP73 is markedly increased in response to MWA of liver cancer.Thus,serum GP73 holds potential as a marker to monitor MWA-induced inflammatory liver injury in need of amelioration.展开更多
Objective: The aim of the present study was to further evaluate the clinical value of single or joint of golgi protein 73 (GP73) and alphafetoprotein (AFP) in diagnosis of hepatocellular (HCC). Methods: One hundred an...Objective: The aim of the present study was to further evaluate the clinical value of single or joint of golgi protein 73 (GP73) and alphafetoprotein (AFP) in diagnosis of hepatocellular (HCC). Methods: One hundred and eighteen, 94 and 47 serum samples from the patients with HCC, chronic liver disease (CLD) and liver cirrhosis (LC) were collected, respectively. Serum levels of AFP and GP73 were assayed with commercial kit according to the manufacturer's instructions. Results: Patients with HCC had higher serum concentration of AFP than that of the patients with CLD (P < 0.01), but was similar to that of the patients with LC. Serum GP73 levels in the patients with CLD or LC were significantly lower than that in the patients from HCC group (P < 0.01). Among 118 HCC patients, the positive rate of GP73 and AFP was 80.5% and 48.3%, respectively (P < 0.001). The ROC curve analysis showed that the AUC value of GP73 was higher than that of serum AFP. Moreover, the sensitivity and the accuracy of GP73 were 77.1% and 82.6%, respectively, which were greater more than that of AFP at 90% specificity (28.8% and 59.8%, respectively). The AUC, the sensitivity and the accuracy of GP73 in combination of AFP (AFP/GP73) were 0.855, 78.0% and 83.0%, respectively, which were similar to that of GP73 alone but were much higher than that of the single marker AFP. Conclusion: For HCC diagnosing, GP73 was more sensitive and specific than AFP. The diagnostic value of AFP/GP73 was similar to GP73 but was much higher than AFP.展开更多
Aim: We measured Golgi protein73 (GP73), alpha-fetoprotein (AFP), and vascular endothelial growth factor (VEGF) expression in primary hepatic cancer (PHC) and assessed their clinical significance. Methods: Forty-five ...Aim: We measured Golgi protein73 (GP73), alpha-fetoprotein (AFP), and vascular endothelial growth factor (VEGF) expression in primary hepatic cancer (PHC) and assessed their clinical significance. Methods: Forty-five PHC and tumor-adjacent specimens and 14 normal liver specimens were examined. GP73, AFP, and VEGF expression was measured via immunohistochemistry and a correlation of protein expression with clinical pathology of PHC was suggested. Results: GP73, AFP, and VEGF expression was significantly higher in PHC and tumor-adjacent tissue compared to tumor-adjacent tissue (0.143 ± 0.018 vs. 0.124 ± 0.027, 0.116 ± 0.026 vs. 0.098 ± 0.014, and 0.126 ± 0.027 vs. 0.092 ± 0.016, respectively;all p 0.088 ± 0.029, 0.098 ± 0.014 vs. 0.073 ± 0.011, and 0.092 ± 0.016 vs. 0.076 ± 0.018, respectively;all p < 0.05), respectively. GP73 expression was positively correlated with pathological grade and cirrhosis, but not with tumor size, nodules, clinical stage and serum AFP. VEGF expression was positively correlated with tumor size, nodules, portal vein tumor thrombus, and clinical stage, but not with the degree of tumor differentiation and serum AFP. Expression of GP73 and VEGF was greater than that of AFP in PHC (both p < 0.05). Conclusion: GP73 is highly expressed in PHC and may be a diagnostic marker. Combined detection of GP73, AFP, and VEGF is helpful for diagnosis of PHC.展开更多
目的基于GALAD模型分析高尔基体糖蛋白-73(Golgi protein 73,GP73)和肝脏硬度测量值(liver stiffness measurement,LSM)在丙型肝炎病毒(hepatitis C virus,HCV)相关肝细胞癌(hepatocellular carcinoma,HCC)患者中表达及诊断价值。方法选...目的基于GALAD模型分析高尔基体糖蛋白-73(Golgi protein 73,GP73)和肝脏硬度测量值(liver stiffness measurement,LSM)在丙型肝炎病毒(hepatitis C virus,HCV)相关肝细胞癌(hepatocellular carcinoma,HCC)患者中表达及诊断价值。方法选取2019年1月至2022年1月西安交通大学第一附属医院榆林医院收治的75例慢性HCV感染并确诊HCC患者(HCC组)和85例HCV感染非HCC患者(对照组)作为研究对象。采用全自动生化仪检测两组患者肝功能生化指标;采用全自动化学发光免疫分析仪分析两组患者甲胎蛋白(α-fetoprotein,AFP)、甲胎蛋白异构体L3(α-fetoprotein-L3,AFP-L3)、异常凝血酶原(des-γ-carboxy prothrombin,DCP)及GP73水平,并根据公式计算GALAD模型得分;采用肝纤维化无创扫描仪测量LSM;采用受试者工作特征曲线分析HCC诊断价值;采用Pearson相关方法进行相关性分析。结果HCC组患者肝功能指标、AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分均显著高于对照组(均P<0.05);HCC组患者不同肿瘤分期亚组AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分比较差异均有统计学意义(均P<0.05),且分期越晚指标水平和GALAD模型评分越高,各分期亚组间差异均有统计学意义(均P<0.05)。相关性分析显示,LSM、GP73水平与GALAD模型评分均呈线性正相关(r=0.622,P<0.001;r=0.532,P<0.001)。LSM、GP73及GALAD三项联合诊断HCC的曲线下面积为0.933,检测敏感度为94.56%,特异度为83.23%,均显著高于单独诊断(均P<0.05)。结论GALAD模型在HCV相关HCC诊断中显示了良好的效能,LSM、GP73作为HCC诊断标志物与GALAD模型评分呈正相关,且联合GALAD模型对HCC表现出更好的诊断效能。展开更多
文摘BACKGROUND Reliable biomarkers of cirrhosis,hepatocellular carcinoma(HCC),or progression of chronic liver diseases are missing.In this context,Golgi protein-73(GP73)also called Golgi phosphoprotein-2,was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells.As a result,GP73 expression was found primarily in biliary epithelial cells,with only slight detection in hepatocytes.However,in patients with acute or chronic liver diseases and especially in HCC,the expression of GP73 is significantly up-regulated in hepatocytes.So far,few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression.AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression.METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA(QUANTA Lite®GP73,Inova Diagnostics,Inc.,Research Use Only)in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa,Greece(n=366)and Debrecen,Hungary(n=266).Aspartate aminotransferase(AST)/Platelets(PLT)ratio index(APRI)was also calculated at the relevant time points in all patients.Two hundred and three patients had chronic hepatitis B,183 chronic hepatitis C,198 alcoholic liver disease,28 autoimmune cholestatic liver diseases,15 autoimmune hepatitis,and 5 with other liver-related disorders.The duration of follow-up was 50(57)mo[median(interquartile range)].The development of cirrhosis,liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines.In particular,the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein(AFP)determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients.RESULTS Increased serum levels of GP73(>20 units)were detected at initial evaluation in 277 out of 632 patients(43.8%).GP73-seropositivity correlated at baseline with the presence of cirrhosis(96.4%vs 51.5%,P<0.001),decompensation of cirrhosis(60.3%vs 35.5%,P<0.001),presence of HCC(18.4%vs 7.9%,P<0.001)and advanced HCC stage(52.9%vs 14.8%,P=0.002).GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score[Area under the curve(AUC)(95%CI):0.909(0.885-0.934)vs 0.849(0.813-0.886),P=0.003].Combination of GP73 with APRI improved further the accuracy(AUC:0.925)compared to GP73(AUC:0.909,P=0.005)or APRI alone(AUC:0.849,P<0.001).GP73 levels were significantly higher in HCC patients compared to non-HCC[22.5(29.2)vs 16(20.3)units,P<0.001)and positively associated with BCLC stage[stage 0:13.9(10.8);stage A:17.1(16.8);stage B:19.6(22.3);stage C:32.2(30.8);stage D:45.3(86.6)units,P<0.001]and tumor dimensions[very early:13.9(10.8);intermediate:19.6(18.4);advanced:29.1(33.6)units,P=0.004].However,the discriminative ability for HCC diagnosis was relatively low[AUC(95%CI):0.623(0.570-0.675)].Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline,was prognostic of higher rates of decompensation(P=0.036),HCC development(P=0.08),and liver-related deaths(P<0.001)during follow-up.CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination.In combination with APRI,its diagnostic performance can be further improved.Most importantly,the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and nonviral chronic liver diseases.
基金supported by grants from the National Key Technology Research and Development Program of China 2012(BAI06B01)the National Natural Science Foundation of China(81201566)+1 种基金the Specialized Research Fund for the Doctoral Program of Higher Education(20121106110002)Wu Jieping Medical Foundation(LDWMF-SY-2011B002)
文摘BACKGROUND： Golgi protein 73 （GP73） is a promising bio- marker of hepatocellular carcinoma （HCC）. It decreases after surgical resection, and resumes upon recurrence, indicating a potential indicator for the effectiveness of the treatment. But changes of GP73 after transcatheter arterial chemoemboliza- tion （TACE） have not been reported so far. This study was to investigate the dynamic changes of GP73 in HCC patients af- ter TACE treatment, and the possible underlying mechanisms in the cell cultures. METHODS： Blood samples were collected from 72 HCC pa- tients, before TACE, at day I and day 30 after TACE. GP73 lev- els were measured by Western blotting. The dynamic changes of GP73 were analyzed and compared with image changes and clinical data. The effects of chemotherapeutic agents （5-FU and pirarubicin） on GP73 expression were tested in three HCC cell lines （HepG2, HCCLM3 and MHCC97H）. RESULTS： The GP73 level was significantly elevated at day 1 and day 30 after TACE in HCC patients compared with that before the procedure （P〈0.05）. There was no statistical differ- ence between the two time points after TACE, nor correlationbetween GP73 levels and dinicopathological features, tumor metastasis, and patient survival. Pirarubicin, not 5-FU, signifi- cantly increased GP73 expression in three cell lines. CONCLUSIONS： Unlike surgical resection which decreases the GP73 level, TACE significantly increased GP73 expression in patients with HCC. No correlations were observed among GP73 levels, tumor characteristics and prognosis of patients with HCC.
基金Supported by the Military Medical Science and Technology Committee of China,No.14MS095the Quanzhou Science and Technology Planning Project,No.2017Z018.
文摘BACKGROUND Microwave ablation(MWA)is an effective treatment option for patients with primary liver cancer.However,it has been reported that the MWA procedure induces a hepatic inflammatory response and injury,which may negatively affect the efficacy of MWA.As such,the discovery of reliable markers to monitor the patient’s response to MWA is needed.Golgi protein 73(GP73)has been shown to be associated with chronic liver disease.To date,the potential value of serum GP73 in the dynamic monitoring during MWA of liver cancer remains unclear.AIM To examine the effects of MWA on the serum levels of GP73 in patients with primary liver cancer.METHODS A total of 150 primary liver cancer patients with a single small lesion(≤3 cm in diameter)were retrospectively enrolled spanning the period between January 2016 and October 2018.All of the patients received MWA for the treatment of primary liver cancer.Serum GP73,alpha-fetoprotein(AFP),and widely used liver biochemical indicators[serum albumin,total bilirubin(TBIL),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)]were compared before MWA and at different time points,including 1,2,and 4 wk following the ablation procedure.RESULTS Complete tumor ablation was achieved in 95.33%of the patients at 1 mo after MWA.The 1-,2-,and 3-year disease-free survival rates were 74.67%,59.33%,and 54.00%,respectively.The serum AFP levels were significantly decreased at 1,2,and 4 wk after MWA;they returned to the normal range at 12 wk after MWA;and they remained stable thereafter during follow-up in those cases without recurrence.In contrast,the serum GP73 levels were significantly increased at 1 and 2 wk after MWA.The serum GP73 levels reached the peak at 2 wk after MWA,started to decline after hepatoprotective treatment with glycyrrhizin and reduced glutathione,and returned to the pretreatment levels at 12 and 24 wk after MWA.Notably,the changes of serum GP73 in response to MWA were similar to those of TBIL,ALT,and AST.CONCLUSION Serum GP73 is markedly increased in response to MWA of liver cancer.Thus,serum GP73 holds potential as a marker to monitor MWA-induced inflammatory liver injury in need of amelioration.
基金Supported by a grant from the International Collaboration Program from Nanjing Science and Technology Bureau (No. 201001139)
文摘Objective: The aim of the present study was to further evaluate the clinical value of single or joint of golgi protein 73 (GP73) and alphafetoprotein (AFP) in diagnosis of hepatocellular (HCC). Methods: One hundred and eighteen, 94 and 47 serum samples from the patients with HCC, chronic liver disease (CLD) and liver cirrhosis (LC) were collected, respectively. Serum levels of AFP and GP73 were assayed with commercial kit according to the manufacturer's instructions. Results: Patients with HCC had higher serum concentration of AFP than that of the patients with CLD (P < 0.01), but was similar to that of the patients with LC. Serum GP73 levels in the patients with CLD or LC were significantly lower than that in the patients from HCC group (P < 0.01). Among 118 HCC patients, the positive rate of GP73 and AFP was 80.5% and 48.3%, respectively (P < 0.001). The ROC curve analysis showed that the AUC value of GP73 was higher than that of serum AFP. Moreover, the sensitivity and the accuracy of GP73 were 77.1% and 82.6%, respectively, which were greater more than that of AFP at 90% specificity (28.8% and 59.8%, respectively). The AUC, the sensitivity and the accuracy of GP73 in combination of AFP (AFP/GP73) were 0.855, 78.0% and 83.0%, respectively, which were similar to that of GP73 alone but were much higher than that of the single marker AFP. Conclusion: For HCC diagnosing, GP73 was more sensitive and specific than AFP. The diagnostic value of AFP/GP73 was similar to GP73 but was much higher than AFP.
文摘Aim: We measured Golgi protein73 (GP73), alpha-fetoprotein (AFP), and vascular endothelial growth factor (VEGF) expression in primary hepatic cancer (PHC) and assessed their clinical significance. Methods: Forty-five PHC and tumor-adjacent specimens and 14 normal liver specimens were examined. GP73, AFP, and VEGF expression was measured via immunohistochemistry and a correlation of protein expression with clinical pathology of PHC was suggested. Results: GP73, AFP, and VEGF expression was significantly higher in PHC and tumor-adjacent tissue compared to tumor-adjacent tissue (0.143 ± 0.018 vs. 0.124 ± 0.027, 0.116 ± 0.026 vs. 0.098 ± 0.014, and 0.126 ± 0.027 vs. 0.092 ± 0.016, respectively;all p 0.088 ± 0.029, 0.098 ± 0.014 vs. 0.073 ± 0.011, and 0.092 ± 0.016 vs. 0.076 ± 0.018, respectively;all p < 0.05), respectively. GP73 expression was positively correlated with pathological grade and cirrhosis, but not with tumor size, nodules, clinical stage and serum AFP. VEGF expression was positively correlated with tumor size, nodules, portal vein tumor thrombus, and clinical stage, but not with the degree of tumor differentiation and serum AFP. Expression of GP73 and VEGF was greater than that of AFP in PHC (both p < 0.05). Conclusion: GP73 is highly expressed in PHC and may be a diagnostic marker. Combined detection of GP73, AFP, and VEGF is helpful for diagnosis of PHC.
文摘目的基于GALAD模型分析高尔基体糖蛋白-73(Golgi protein 73,GP73)和肝脏硬度测量值(liver stiffness measurement,LSM)在丙型肝炎病毒(hepatitis C virus,HCV)相关肝细胞癌(hepatocellular carcinoma,HCC)患者中表达及诊断价值。方法选取2019年1月至2022年1月西安交通大学第一附属医院榆林医院收治的75例慢性HCV感染并确诊HCC患者(HCC组)和85例HCV感染非HCC患者(对照组)作为研究对象。采用全自动生化仪检测两组患者肝功能生化指标;采用全自动化学发光免疫分析仪分析两组患者甲胎蛋白(α-fetoprotein,AFP)、甲胎蛋白异构体L3(α-fetoprotein-L3,AFP-L3)、异常凝血酶原(des-γ-carboxy prothrombin,DCP)及GP73水平,并根据公式计算GALAD模型得分;采用肝纤维化无创扫描仪测量LSM;采用受试者工作特征曲线分析HCC诊断价值;采用Pearson相关方法进行相关性分析。结果HCC组患者肝功能指标、AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分均显著高于对照组(均P<0.05);HCC组患者不同肿瘤分期亚组AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分比较差异均有统计学意义(均P<0.05),且分期越晚指标水平和GALAD模型评分越高,各分期亚组间差异均有统计学意义(均P<0.05)。相关性分析显示,LSM、GP73水平与GALAD模型评分均呈线性正相关(r=0.622,P<0.001;r=0.532,P<0.001)。LSM、GP73及GALAD三项联合诊断HCC的曲线下面积为0.933,检测敏感度为94.56%,特异度为83.23%,均显著高于单独诊断(均P<0.05)。结论GALAD模型在HCV相关HCC诊断中显示了良好的效能,LSM、GP73作为HCC诊断标志物与GALAD模型评分呈正相关,且联合GALAD模型对HCC表现出更好的诊断效能。
