联合检测血清GP73和AFP对原发性肝癌诊断价值的探讨

目的:探讨血清高尔基体糖蛋白(GP73)对原发性肝癌的诊断价值,分析GP73和甲胎蛋白(AFP)联合检测对原发性肝癌诊断的临床意义。方法:应用双抗体夹心酶联免疫定量测定方法,检测144例原发性肝细胞癌、50例肝硬化、100例乙型肝炎、50例其他恶性肿瘤、26例肝良性肿瘤、84例HBV携带者和50名健康体检者血清中GP73的浓度,应用临床电化学发光法测定AFP作为参照。结果:原发性肝细胞癌患者血清GP73水平明显高于肝硬化、乙型肝炎、其他恶性肿瘤、肝良性肿瘤、HBV携带者和正常人对照组,P<0.05。通过ROC曲线设定GP73浓度,GP73为64ng/mL作为肝癌诊断的临界值切点(cut-off)时,GP73检测原发性肝细胞癌的敏感度和特异度达到最高,分别为83.3%和88.3%。在原发性肝细胞癌组,GP73诊断肝癌的敏感度和特异度与AFP比较差异有统计学意义(83.3%vs 72.2%,88.3%vs 76.7%),P<0.05;GP73+AFP联合检测可使敏感性提高到94.4%,特异性为65.6%。结论:GP73诊断原发性肝细胞癌有较好的敏感性和特异性,而GP73与AFP联合检测的敏感性比单项检测均高。联合检测血清中的GP73和AFP可提高原发性肝细胞癌的诊断价值。

Diagnostic value of serum GP73 and AFP detection in primary hepatic carcinoma

OBJECTIVE:To explore the diagnostic value of serum GP73 in the patient of primary hepatic carcinoma(PHC),and discuss the diagnostic value of the joint roles of serum GP73 and AFP in the diagnosis of PHC.METHODS: ELISA method was used to detect the serum level of GP73 in 144 cases of PHC,50 cases of hepatic cirrhosis,100 cases of hepatitis,50 cases of other malignant tumors,26 cases of liver benign tumor,84 cases of hepatitis carriers and 50 cases of healthy people.The electrochemical luminescence method was used to detect the serum level of AFP of the all,and the level of AFP was as a comparison.RESULTS: The level of serum GP73 in the group of PHC were significantly higher than that of hepatic cirrhosis,hepatitis,other malignant tumors,liver benign tumor,hepatitis carriers and healthy people(P<0.05),the critical value for GP73 was determined to be 64.4 ng/mL through the ROC curves,under the critical value the sensitivity and specificity of the GP73 was 83.3% and 88.3%,and these were the best.The difference of GP73 and AFP in the group of PHC was statistically significant(83.3% vs 72.2%,88.3% vs 76.7%,P<0.05),the diagnostic sensitivity of the joint roles of serum GP73 and AFP was increased to 94.4%,and the specificity was 65.6%.CONCLUSIONS: The GP73 has better sensitivity and specificity than AFP.The sensitivity of the joint test is better than the single detection.The joint roles of serum GP73 and AFP can improve PHC diagnostic value.