新的肝癌血清标记物GP73在肝癌诊断中的初步研究

目的 初步探讨蛋白组学结果获得的GP73在以乙肝为基础的HCC中的敏感性和特异性.方法 本研究共收集173例血清,其中健康人99例,非肝病患者12例,HBV携带者25例,肝癌患者37例.采用Western印迹方法检测各组人群血清中GP73蛋白的表达,并定量分析结果;确定对照组人群的正常基线水平;采用电化学发光法检测相应人群血清中AFP的量.计算GP73在诊断HCC的敏感性和特异性,并与AFP结果进行对比.同时检测了少量的HCC患者的围手术期GP73的表达,其他肝脏良、恶性病变GP73的表达和GP73同HCC大小分级间的关系等.结果 正常人群和非肝病患者的GP73水平相当(P=0.2925),可共同作为对照组.肝癌组血清GP73水平与对照组及乙肝携带者组相对值相比显著增高(40.36±64.43 vs 2.80±5.19和7.82±10.72,P=0.0015和0.0058).GP73诊断HCC的敏感性达到76.9%,特异性达到92.8%,与本组患者AFP的敏感性(48.6%)相比,前者有显著增高.有限的病例还提示,GP73在HCC患者术后1周内仍维持在一定水平上,而术后1年半～2年下降明显,可能提示了GP73蛋白在血中的降解情况;GP73在其他肝脏良性疾病中不增高;在胆管细胞型肝癌中,有部分(4/6)增高,增高程度介于肝癌组和HBV携带者组之间;与肿瘤大小和分级没有明显关联.结论 国内初步研究揭示GF73在以乙肝为基础的HCC患者中的高敏感性,它有可能成为我国临床上一个新的更有效的肝癌标记物.

Significance of Golgi glycoprotein 73, a new tumor marker in diagnosis of hepatocellular carcinoma: a primary study

OBJECTIVE: To evaluate the sensitivity and specificity of Golgi glycoprotein 73 (GP73) for the diagnosis of hepatitis B related hepatocelluar carcinoma (HCC). METHODS: Western blotting was used to detect the serum GP73level in 25 patients being HBV carrier, 24 HCC patients, 12 patients with non-liver disease, and 99 healthy controls. Serum alpha-fetoprotein (AFP) was detected by electrochemiluminescence reaction. The levels of sensitivity and specificity of serum GP73 in diagnosing HCC were compared with those of AFP. The serum GP73 levels of some HCC patients during the perioperative period were compared. RESULTS: The serum GP73 level of the HCC patients, all HBV positive, was (40.36 +/- 64.43) relative units, significantly higher than those of the HBV carriers, non-liver patients, and healthy controls (7.82 +/- 10.72), (4.48 +/- 5.70), and (2.59 +/- 5.12) relative units respectively, all P < 0.01]. There was no difference of GP73 levels between the healthy controls and the patients of non liver diseases (P = 0.2925). The sensitivity of GP73 for the diagnosis of HCC was 76.9%, significantly higher than that of AFP (48.6%). The specificity for the diagnosis of HCC of GP73 was 92.9%. Findings in a few HCC patients showed that the GP73 level remained not remarkably lowered within a week after surgical resection; but became lower 1.5-2 years after surgery. There was no raise of GP73 in the patients with non- malignant liver lesions. The GP73 levels of 4 of the 6 intra-hepatic cholangiocarcinoma patients were between those of the HCC patients and HBV carriers. CONCLUSION: Serum GP73 has higher sensitivity and specificity in diagnosis of hepatitis B-related HCC than AFP, and it can become a new effective HCC tumor marker.