血清高尔基体蛋白73诊断肝细胞癌价值探讨

目的评价血清高尔基体蛋白73（GP73）在肝细胞癌（HCC）诊断中的价值。方法选择400例HCC、100例肝硬化（LC）、100例慢性乙型肝炎（CHB）患者和200例健康对照者（HC），分别采用ELISA和电化学发光法检测血清GP73和甲胎蛋白（AFP）水平；采用受试者工作特征曲线下面积（ AUROC）评估两者对HCC的诊断效能。结果 HCC、CHB和LC患者血清GP73水平分别为243.6±163.1ng/ml、85.6±35.3ng/ml和81.9±36.4ng/ml，均显著高于健康对照组（78.2±33.9ng/ml，P〈0.05），但在CHB和LC组及HC三组间无统计学差异；GP73和AFP的最佳诊断临界值分别为150.7ng/ml和19.7ng/ml，GP73的AUROC为0.846，灵敏性为69.2%，特异度为90.5%，均显著优于AFP（AUROC为0.828，灵敏性为57.6%，特异度为88.1%，P〈0.05）；GP73与AFP两者联合检测可以进一步提高对HCC的诊断准确性（AUROC为0.887，灵敏性为73.5%，特异度为88.0%）；在AFP阴性与阳性的两组HCC患者中，GP73灵敏性和特异度无显著性差异。结论血清GP73对HCC的诊断效能高于AFP，两者联合检测可以进一步提高诊断效能。

The accuracy of serum golgi protein-73 le vels in diagnosis of patients with hepatocellular carcinoma

Objective To explore the accuracy of serum golgi protein-73 levels in diagnosis of patients with hepatocellular carcinoma （HCC）. Methods 400 patients with HCC,200 with liver cirrhosis （LC）,100 with chronic hepatitis B（CHB）and 100 healthy controls（HC）were collected in this study. Enzyme linked immunosorbent assay and electrochemiluminescence immunoassay were used to detect serum GP-73 and alpha fetal protein （AFP）,respectively. The ability of GP73 and AFP in diagnosis of patients with HCC was evaluated by the area under the receiver operating characteristic curves （AUROC）. Results Serum GP73 levels in patients with HCC, CHB and LC were 243.6±163.1ng/ml,85.6±35.3ng/ml and 81.9±36.4ng/ml,respectively,all of which were significantly higher than that in HC （78.2±33.9ng/ml,P〈0.05）;The optimal cut-off value of GP-73 and AFP for diagnosis of HCC were 150.7ng/ml and 19.7ng/ml,respectively and the AUROC of GP73 was 0.846,with a sensitivity of 69.2%and a specificity of 90.5%,which were both better than AFP（0.828,57.6% and 88.1%,respectively,P〈0.05）;When GP73 in combination with AFP,they led to an enhanced sensitivity of HCC detection up to 73.5% and the AUROC was 0.887;There was no difference in the positive rate of GP-73 between AFP positive or negative HCC subjects. Conclusion Serum GP-73 has a better accuracy than AFP for the diagnosis of HCC,and serum GP73 in com-bination with AFP might further increase the accuracy for HCC diagnosis.