血清磷酯酰肌醇蛋白聚糖3与高尔基体蛋白73检测在肝细胞癌诊断中的意义

目的：评价血清磷酯酰肌醇蛋白聚糖3（gpc3）和高尔基体蛋白73（gp73）的检测对肝细胞癌（HCC）的筛查作用。方法采集70例 HCC 癌及肝硬化（肝脏再生结节）患者基线时外周血。应用 ELISA 法检测患者血清 gpc3和gp73，并与其血清AFP水平做对照。结果 HCC组gpc3、gp73测量值显著高于肝硬化组（P＜0．01）；gpc3诊断HCC的截断值＞9．3μg/L，AUC＝0．956，灵敏度为89．74％，特异度为96．77％，阳性预测值为97．2％，阴性预测值为88．2％，约登指数为0．8652，阳性似然比27．82，阴性似然比0．11，gp73诊断 HCC 的截断值＞77．68μg/L，AUC＝0．937，灵敏度为92．31％，特异度为83．87％，阳性预测值为87．8％，阴性预测值为89．7％，约登指数0．7618，阳性似然比5．72，阴性似然比0．092。结论血清gpc3与gp73水平可用于 HCC的筛查。

Clinical study of phosphatidylinositol proteoglycan 3 and Golgi protein 73 on screen of early hepatocellular carcinoma

Objective To evaluate the effects of phosphatidylinositol proteoglycan 3 （GPC3 ）and Golgi protein 73 （GP73）levels on screen of early primary hepatocellular carcinoma （HCC）. Methods Seventy patients with HCC or liver cirrhosis （hepatic regenerative nodules）were enrolled. GPC3 and GP73 from peripheral serum were assessed by ELISA at baseline,and the relationships between GPC3/GP73 and liver histology/AFP were analyzed,respectively. Results GPC3 and GP73 levels in liver cancer group were significantly higher than those in liver cirrhosis group （P〈 0.001）;for GPC3, the cut-off value for HCC was 9.3 μg/l （AUC= 0.956）. Relevant indexes included sensitivity （89.74% ）,specificity （96.77% ）,positive predictive value （97.2% ）,negative predictive value （88.2% ）,the Youden＇s index （0.8652）,positive likelihood ratio （AUC= 0.956,＋LR,27.82）,and negative likelihood ratio （-LR,0.11）;for GP73,the cut-off value was 77.68 ng/ml （AUC= 0.937）with sensitivity of 92.31% ,specificity of 83.87% ,positive predictive value of 87.8% , negative predictive value of 89.7% ,the Youden index of 0.7618,positive likelihood ratio （AUC= 0.937,＋LR）of 5.72 and negative likelihood ratio （-LR）of 0.092. Conclusion GPC3 and GP73 levels can be used for screening early HCC.