血清高尔基体糖蛋白73在肝细胞癌诊断中的作用

目的 探讨血清高尔基体糖蛋白73(GP73)在肝细胞癌(HCC)早期诊断中的作用.方法 采用酶联免疫吸附试验(ELISA)定量检测43例体检正常者(正常对照)、110例慢性肝炎或肝硬化(CH/LC)患者和219例HCC患者血清中GP73水平,计算ROC曲线下面积及GP73对HCC诊断的敏感性与特异性.结果 正常对照组、CH/LC组和HCC组GP73分别为(22.1±8.5)ng/ml、(81.4±57.2)ng/ml和(271.5±202.3)ng/ml,HCC组GP73水平明显高于CH/LC组(P＜0.001).GP73的ROC曲线下面积是0.857,以100 ng/ml作为cut-off值,GP73诊断HCC的敏感性为76.7%,特异性为73.2%.在149例甲胎蛋白(AFP)＜400 ng/ml的HCC样本中,有108例(72.5%)GP73＞100 ng/ml.对4例AFP＜400ng/ml的HCC患者连续检测表明,GP73与治疗效果及预后有一定的相关性.结论 GP73可作为HCC早期诊断及治疗效果监测的指标,尤其对AFP＜400 ng/ml的HCC患者有较好临床意义.     

血清胱抑素C、5’-核苷酸酶及甲胎蛋白联合检测在肝细胞癌诊断中的应用

目的 探讨血清胱抑素C（Cys-C）、5′-核苷酸酶（5′-NT）和甲胎蛋白（AFP）单独及联合检测在肝细胞癌（HCC）诊断中的应用,为早期诊断及预后评估提供依据.方法 分别采用胶乳增强免疫透射比浊法、过氧化物酶法和电化学发光免疫分析法测定148例HCC患者（HCC组）、135例肝硬化患者（肝硬化组）、155例肝炎患者（肝炎组）和100名健康体检者（对照组）的血清Cys-C、5′-NT和AFP含量,比较其差异,计算敏感度、特异度及约登指数,并应用受试者工作特征（ROC）曲线进行分析.结果 血清Cys-C、5’-NT和AFP的水平在HCC组、肝硬化组、肝炎组和对照组之间差异均具有统计学意义（F值分别为12.35、42.25、58.12,P值均为0.000）.三者联合检测HCC的敏感度为100％,较单项及两两联合检测的敏感度均高,差异有统计学意义（P＜0.05）,而特异度为78.97％;二者联合检测HCC的ROC曲线下面积为0.977,较单项及两两联合检测结果均高,差异亦具有统计学意义（P＜0.05）.结论 血清Cys-C、5’-NT和AFP联合检测可提高HCC诊断的敏感性和准确性,对HCC的早期诊断具有重要价值,值得在临床上推广应用.     

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。     

血清AFP-L3、GP73检测联合CT扫描在肝细胞癌诊断中的价值

目的:检测肝病患者血清中甲胎蛋白异质体(AFP-L3)和高尔基体蛋白73(GP73)浓度,分析肝病患者病灶CT平扫加增强扫描后经处理技术得到二维及三维重建图像,探讨联合运用AFP-L3、GP73浓度检测与CT扫描两种技术在肝细胞癌(hepatocellular carcinoma,HCC)诊断中的价值。方法:采用酶联免疫吸附法检测肝病患者血清AFP-L3、GP73浓度,运用受试者工作特征曲线(recover operation characteristic,ROC)确定AFP-L3、GP73浓度诊断HCC的cut-off值。分析141例肝病患者总共164个病灶的CT扫描后经处理技术得到二维及三维重建图像而诊断HCC,探讨采用AFP-L3、GP73浓度测定与CT增强扫描及这两种方法联合应用在HCC的检出与定性诊断方面的价值。结果:HCC组AFP-L3浓度(113.58±63.62)ng/ml明显高于良性肝病组[(23.19±34.54)ng/ml,P<0.001],绘制AFP-L3浓度诊断HCC的ROC曲线,AFP-L3浓度38.47ng/ml为诊断HCC的cut-off值,诊断敏感性为81.08%,特异性为88.06%,诊断正确率为87.23%;HCC组GP73浓度(126.55±49.56)ng/ml明显高于良性肝病组[(56.97±26.48)ng/ml,P<0.001],绘制GP73浓度诊断HCC的ROC曲线,GP73浓度69.44ng/ml为诊断HCC的cut-off值,诊断敏感性为75.68%,特异性为91.04%,诊断正确率为88.65%。CT扫描诊断HCC的灵敏度为82.43%,特异度为91.04%,诊断正确率为90.07%。联合AFP-L3、GP73浓度检测与CT扫描诊断HCC的灵敏度为85.14%,特异度为92.53%,诊断正确率为92.19%。结论:联合运用血清AFP-L3、GP73浓度检测及CT扫描两种技术对HCC诊断灵敏度、特异度、诊断正确率较运用单一技术均有所提高,联合运用两种技术对HCC的准确早期诊断具有积极的意义。     

血清肿瘤标志物的联合动态检测在原发性肝癌诊断中的价值

目的 探讨血清肿瘤标志物甲胎蛋白（AFP）、恶性肿瘤特异性生长因子（TSGF）、高尔基体膜蛋白73（GP73）、骨桥蛋白（OPN）联合动态检测在原发性肝癌诊断中的应用价值.方法 选取122例原发性肝癌患者、50例肝脏良性病变患者和50名健康体检者为研究对象,采用电化学发光法检测其血清AFP、TSGF、GP73水平,酶联免疫吸附试验法（ELISA）检测OPN水平,分析血清肿瘤标志物AFP、TSGF、GP73和OPN在原发性肝癌诊断中的临床应用价值.结果 原发性肝癌患者血清AFP、TSGF、GP73和OPN水平明显高于肝脏良性病变患者和健康对照者,差异均有统计学意义（均P＜0.01）;原发性肝癌患者血清肿瘤标志物水平与患者年龄、性别无关（均P＞0.05）,与病灶大小、肿瘤数目、临床分期、腹腔积液、肝硬化、门静脉侵犯、转移、复发、治疗后相关（均P＜0.05）.AFP、TSGF、GP73和OPN单项用于诊断原发性肝癌的敏感度分别为57.38％、68.85％、70.49％、69.67％;AFP＋TSGF、AFP＋TSGF＋GP73的敏感度分别为80.33％、85.25％;4项肿瘤标志物联合检测可使敏感度提高到98.36％,准确度提高到95.65％,与各单项及部分组合检测比较差异均有统计学意义（均P＜0.05）.结论 血清肿瘤标志物AFP、TSGF、GP73和OPN可作为诊断原发性肝癌的辅助手段,4项肿瘤标志物联合检测的敏感性及准确性明显提高,从而减少误诊、漏诊,有利于肝癌的早期诊断、临床早期干预.     

鸟氨酸氨甲酰基转移酶/丙氨酸氨基转移酶和甲胎蛋白联合检测在肝细胞癌中的诊断价值

目的：研究鸟氨酸氨甲酰基转移酶／丙氨酸氨基转移酶（OCT／ALT）比值和甲胎蛋白（AFP）联合检测对肝细胞癌的诊断价值。方法：测定61例肝细胞癌、49例慢性肝炎、45例肝硬化和51名健康体检者血清OCT／ALT比值和AFP水平，应用受试者工作特征曲线（ROC）进行评价。结果：肝细胞癌组血清OCT／ALT和AFP水平高于对照组、肝炎组和肝硬化组，差异有统计学意义（P〈0．05）。血清OCT／ALT和AFP的ROC曲线下面积分别为0．808和0．758。OCT／ALT的最优截断点约为3．2，灵敏度和特异度为68．3％和90．3％。AFP的最优截断点约为400ng／ml，灵敏度和特异度分别为60．7％和80．0％。结论：通过ROC曲线评价，在肝细胞癌的诊断中，血清OCT／ALT和AFP联合检测优于两项指标的单独检测。     

应用ROC曲线评价5'-NT和甲胎蛋白联合检测在早期原发性肝细胞癌诊断中的价值

目的:应用ROC曲线评价血清5'-核苷酸酶（5'-NT）和甲胎蛋白（AFP）联合检测在原发性肝细胞癌（hepatocellular carcinoma,HCC）诊断中的应用,以寻找一组诊断HCC更敏感的指标,为早期诊断及治疗提供依据。方法:分别采用过氧化物酶法及电化学发光免疫分析法测定132例肝细胞癌患者（肝细胞癌组）、85例肝硬化患者（肝硬化组）、138例肝炎患者（肝炎组）和100例健康体检者（对照组）的血清5'-NT和AFP的浓度,并使用统计学软件对结果进行处理及分析。结果:血清5'-NT和AFP的水平在HCC组、肝硬化组、肝炎组和对照组间存在显著性差别,差异具有统计学意义（P＜0.05）;二者联合检测HCC的敏感度为93.94%,较单项检测高（P＜0.05）,特异度为84.10%;二者联合诊断HCC的曲线下面积为0.948,较单项高,差异亦具有统计学意义（P＜0.05）。结论:血清5'-NT和AFP联合检测可提高HCC诊断的敏感度和准确度,对HCC的早期诊断具有十分重要的临床价值。     

联合检测AFP-L3％、GP73、GPC3在AFP低值原发性肝癌诊断中的价值

目的:本研究探讨血清甲胎蛋白异质体3百分含量(AFP-L3％)、高尔基蛋白73(GP73)、磷脂酰肌醇蛋白聚糖3(GPC3)联合检测在AFP低值原发性肝癌(primary hepatic carcinoma,PHC)诊断中的临床价值.方法:选取58例AFP低值原发性肝细胞癌患者(PHC组)、62例良性肝病患者(良性肝病组)和55例体检健康者纳入本研究.采用微量离心柱法分离AFP-L3,电化学发光法检测AFP与AFP-L3,计算AFP-L3％.依据试剂盒推荐以AFP-L3％≥10％作为阳性界值.采用酶联免疫吸附法检测GP73、GPC3血清浓度,其诊断PHC的cut-off值由受试者工作特征曲线(recover operation characteristic,ROC)确定.结果:PHC组AFP-L3％ (16.58％±5.12％)明显高于良性肝病组(9.16％±3.86％)和健康对照组(5.11％ ±2.03％,P＜0.001);PHC组GP73浓度(167.83±69.56) ng/ml明显高于良性肝病组(59.43±28.37) ng/ml和健康对照组(10.39±4.22) ng/ml,P＜0.001;PHC组GPC3浓度(116.52±48.21) μg/L明显高于良性肝病组(28.43±11.25)μg/L和健康对照组(3.25±1.46) μg/L,P＜0.001.以AFP-L3％≥10％作为阳性界值诊断PHC,诊断灵敏度为82.76％,特异度为82.05％,诊断正确率为82.28％;依据ROC曲线,GP73诊断PHC的cut-off值为81.86 ng/ml,诊断灵敏度为77.59％,特异度为82.91％,诊断正确率为81.14％;依据ROC曲线,GPC3诊断PHC的cut-off浓度为35.43μg/L,诊断灵敏度为70.69％,特异度为77.78％,诊断正确率为75.43％;联合检测AFP-L3％、GP73、GPC3水平诊断PHC的灵敏度为87.93％,特异度为84.62％,诊断正确率为85.71％.结论:肿瘤标志物AFP-L3％、GP73、GPC3可作为早期诊断和鉴别诊断PHC的良好指标,联合检测可显著提高诊断正确率.     

去γ-羧基凝血酶原对原发性肝细胞癌的诊断价值

目的：探讨血清肿瘤标志物去γ-羧基凝血酶原（des-γ-carboxy prothrombin,DCP）对原发性肝细胞癌（hepatocellular carcinoma,HCC）的诊断价值。方法：172例研究对象分为正常对照组（25例）、慢性肝炎组（20例）、肝硬化组（51例）及HCC组（76例）,用酶联免疫法（ELISA）测定血清DCP浓度,同时用电化学发光免疫法（ECLIA）测定血清AFP浓度,对比分析DCP、AFP及两者联合检测对HCC患者诊断的灵敏度、特异度和准确度,并对HCC病灶大小、门静脉癌栓浸润及背景肝病等临床病理特征与DCP、AFP作相关性分析。结果：正常对照组、慢性肝炎组、肝硬化组及HCC组的DCP平均浓度分别为17．72&#177;9．59、26．12&#177;12．64、37．45&#177;18．26和806．71&#177;639．79mAU／ml,可见DCP浓度在四组间呈递增趋势（P〈0．05）,且HCC组DCP浓度显著高于其它三组（P〈0．01）。正常对照组、慢性肝炎组、肝硬化组及HCC组AFP平均浓度分别为7．93&#177;5．42、14．59&#177;11．91、16．29&#177;14．10和547．47&#177;544．98ng／ml,HCC组AFP浓度也明显高于其它三组（P〈0．01）。统计分析显示血清DCP、AFP对HCC诊断阳性率分别为78．95％、73．68％,而两项联合使用对HCC诊断阳性率提高至89．47％。较大病灶（〉5cm）、门静脉癌栓（PVI）阳性HCC患者的DCP浓度高于小病灶、PVI阴性HCC患者;HBSAg阳性HCC患者DCP浓度高于HBSAg阴性HCC患者。结论：DCP对HCC具有较好的诊断价值,其浓度与HCC的病灶大小、门静脉癌栓浸润等,临床病理特征相关,且不受HBV感染的影响,适用于我国以HBV感染为背景肝病的HCC诊断,其灵敏度及特异度较AFP高,联合DCP、AFP检测能明显提高HCC的诊断率。     

HIF-1α和VEGF鉴别诊断结核性胸腔积液与肺癌伴癌性胸腔积液的意义

目的 探讨缺氧诱导因子-1α（HIF-1α）和血管内皮生长因子（VEGF）在结核性胸腔积液与肺癌伴癌性胸腔积液鉴别诊断中的意义。方法 从本院2012年1月至2013年12月的108例胸腔积液患者中筛选出符合要求的45例患者,根据胸腔积液性质分为肺癌伴癌性胸腔积液组（CA组）25例和结核性胸腔积液组（TB组）20例,检测两组血清及胸水中HIF-1α、VEGF水平并计算胸水与血清VEGF比值（胸水／血清VEGF）和胸水与血清HIF-1α比值（胸水／血清HIF-1α）,采用受试者工作特征曲线（ROC）分析HIF-1α、VEGF、胸水／血清HIF-1α和胸水／血清VEGF鉴别肺癌伴癌性胸腔积液和结核性胸腔积液的效能,分析胸水HIF-1α、血清HIF-1α、胸水VEGF及血清VEGF两两联合及四者联合的敏感度、特异度和诊断符合率。结果 CA组胸水HIF-1α水平为（2.29±0.89） ng／ml, 高于TB组的 （0.88±0.69）ng／ml,差异有统计学意义（P<0.01）;CA组血清HIF-1α水平为（2.00±1.00）ng／ml,TB组为（1.85±0.77）ng／ml,差异无统计学意义（P＞0.05）。CA组和TB组胸水VEGF水平分别为（1035.31±687.64）pg／ml和（732.97±493.61）pg／ml,血清VEGF水平分别为（491.25±278.33）pg／ml和（463.42±288.15）pg／ml,差异无统计学意义（P＞0.05）。CA组胸水／血清HIF-1α水平为1.26±0.49,高于TB组的0.56±0.55,差异有统计学意义（P<0.01）;CA组和TB组的胸水／血清VEGF水平分别为2.85±2.73和2.02±1.58,差异无统计学意义（P＞0.05）。在结核性胸腔积液与肺癌伴癌性胸腔积液的鉴别诊断中,单独检测胸水HIF-1α的敏感度为88%,特异度为85%,单独检测胸水／血清HIF-1α的敏感度为92%,特异度为85%,而联合检测血清及胸水HIF-1α和VEGF的敏感度为64%,特异度为100%。结论 胸水HIF-1α和胸水／血清HIF-1α水平对于结核性胸腔积液与肺癌伴癌性胸腔积液鉴别诊断有一定临床意义。联合检测血清HIF-1α、胸水HIF-1α、血清VEGF和胸水VEGF可提高特异度。     

血清AFP、GP73、GPC3单独及联合检测对肝细胞癌的诊断价值

目的探讨血清中AFP、GP73、GPC3三种肿瘤标志物在肝细胞癌(hepatocellular carcinoma,HCC)中的诊断价值及联合检测的意义。方法检测了45例HCC患者、32例乙肝携带者和30例正常体检者血清中AFP、GP73、GPC3的含量并进行相关分析。结果 AFP、GP73、GPC3用于诊断HCC时的敏感度和特异度分别是57.8%和90.6%、80.0%和98.3%、31.1%和92.3%,ROC曲线下面积分别为0.874、0.963、0.507;AFP与GP73联合,AFP与GPC3联合,GP73与GPC3联合以及三种标志物联合时敏感度和特异度分别是93.9%和88.9%、73.3%和83.8%、84.4%和91.5%、95.6%和82.1%,ROC曲线下面积分别为0.976、0.821、0.963、0.976。结论联合检测血清中AFP和GP73对HCC的诊断具有重要价值,血清GPC3检测对HCC的诊断意义较小。     

GP73在肝细胞癌诊断中的应用价值

目的 探讨高尔基蛋白73（Golgi protein-73,GP73）在肝细胞癌（heptocellular carcinoma,HCC）患者血清中的表达及其对HCC的诊断价值。方法 收集人外周血清62例,其中HCC 31例（HCC组）,健康志愿者31名（健康对照组）。采用Western blot法检测两组血清中GP73 的表达,制作受试者工作特征曲线（receiver operating characteristic,ROC）,以曲线下面积（area under curve,AUC）评价GP73诊断HCC的效能。结果 HCC组和健康对照组血清中GP73阳性表达率分别为74.19%（23/31）和9.68%（3/31）,两组比较差异有统计学意义（P＜0.01）。当设定GP73浓度82.2 ng/mL为诊断临界值时,ROC曲线下面积为0.823,其检测HCC的敏感度和特异度均达到最优,分别为90%和78%。结论 GP73诊断HCC具有较高的敏感度和特异度,是较好的HCC诊断标志物。     

GP73在肝细胞癌诊断中的价值

目的:探讨GP73(Golgi protein-73)在肝细胞癌诊断中的价值.方法:收集外周血血清504例,其中肝细胞癌144例、肝硬化50例、乙型病毒性肝炎100例、乙型肝炎病毒携带者84例、其他恶性肿瘤50例、肝良性肿瘤26例和健康志愿者50例;应用双抗体夹心酶联免疫定量测定方法和电化学发光法检测血清中GP73和甲胎蛋白(α-fetoprotein,AFP)的表达水平.结果:肝细胞癌组血清GP73的表达水平显著高于其他各组(P＜0.05);受试者工作特征(receiver operating characteristic,ROC)曲线设定GP73临界值为64 ng/mL时,GP73诊断肝细胞癌的灵敏度和特异度分别为83.3％和88.3％,显著高于AFP(72.2％和76.7％),差异有统计学意义(P＜0.05);血清GP73联合AFP检测诊断肝细胞癌的灵敏度可达94.4％.结论:血清GP73的表达水平用于诊断肝细胞癌的灵敏度和特异度优于AFP,血清GP73联合AFP检测可提高肝细胞癌的诊断率.     

GP73, a resident Golgi glycoprotein,is sensibility and specificity for hepatocellular carcinoma of diagnosis in a hepatitis B-endemic Asian population

Golgi protein-73 (GP73) is a newly identified candidate serum marker for HCC, but GP73 study now is lesser in Asian population. The aims of this study were to determine how GP73 is detected in the serum of healthy, hepatitis B, cirrhosis and HCC by western blotting and RT-PCR, and to establish the sensitivity and specificity of serum GP73 protein and RNA for diagnosing HCC. Serum GP73 was detected by western blotting and RT-PCR, and quantified by densitometric analysis. GP73 was measured in serum from 124 patients with various forms of liver. AFP was tested using commercially available electrochemiluminescence immunoassay. The median sGP73 in patients with HBV-related HCC was significantly higher (P < 0.001) than in healthy individuals and in patients with other diseases. When sGP73 protein was used to detect HBV-related HCC, it had a sensitivity of 77.4% and a specificity of 83.9%, at the optimal cut-off value of 7.4 relative units. The area under the receiver–operating characteristic curve was 0.89. GP73 RNA in patients with HBV-related HCC had a sensitivity of 87.1% and a specificity of 83.9% and AUROC of 0.92. AFP in patients with HCC had a sensitivity of 48.4% and a specificity of 96.8% and AUROC of 0.77. GP73 protein and RNA can be found in the serum of patients with HBV-related HCC obviously higher than of other liver diseases in Asian. GP73 was better than AFP for the diagnosis of HBV-related HCC. RT-PCR is a more sensitive and superior method of quantification than Western blot. Furthermore, our data need to be confirmed in larger cohorts of patients.     

血清标志GlyPican-3对肝细胞癌诊断价值初步评价

目的：探讨人血清磷脂酸肌醇蛋白聚糖-3（GlyPican-3）和甲胎蛋白（a—fetoprotein，AFP）联合检测对肝细胞癌（hepatocellularcarcinoma，HCC）诊断的临床价值。方法：收集2011—1l—02-2013—01—13遵义市第一人民医院174例和青岛市城阳区人民医院44例，门诊和肝胆外科人外周血血清218例，其中HCC54例，肝硬化36例，肝炎40例，肝良性肿瘤18例，其他恶性肿瘤40例，健康志愿者30名。双抗体夹心酶联免疫定量测定方法和电化学发光法检测血清中GlyPican-3和AFP的表达水平，结果以中位数（M）表示。制作受试者工作特征（receiveroperatingcharacteristic，ROC）曲线，以曲线下面积（areaundercurve，AUC）反映诊断的准确性。结果：HCC组血清GlyPican-3的表达水平为654．67ρg／mL，显著高于肝硬化组的32．83ρg／mL、肝炎组的33．04ρg／mL、肝良性肿瘤组的15．14ρg／mL、其他恶性肿瘤组的25．82ρg／mL和健康志愿者组的3．90ρg／mL，P值均〈0．001；GlyPican-3组AUC为0．883，95％CI：0．833～0．923；AFP组为0．802，95％CI：0．743～0．853；GlyPican-3和AFP联合检测为0．945，95％CI：0．905～O．971。GlyPican-3和AFP联合检测显著高于单个检测指标，Z值分别为5．944和3．409，P值分别为〈0．001和0．007。GlyPican-3取最佳临界值为60ρg／mL时，GlyPican-3诊断HCC的灵敏度和特异度分别为85．18％（46／54）和73．78％（121／164）；GlyPican-3联合AFP检测诊断HCC的灵敏度可达96．29％（52／54）。血清GlyPican-3的表达水平随HCC的临床分期增加而升高，H=4．571，P=0．025。结论：血清GlyPican-3的表达水平对于HCC具有较高的诊断价值，血清GlyPican-3联合AFP检测可提高HCC的诊断率。血清GlyPican-3的表达水平与，临床分期有关。     

高尔基体糖蛋白-73与AFP单独及联合检测对原发性肝癌诊断的临床价值分析

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.     

Cytokeratin-18 in Diagnosis of HCC in Patients with Liver Cirrhosis

Background: Hepatocellular carcinoma (HCC) is a common malignancy that occurs secondary to viral hepatitis B and C cirrhosis under the influence of environmental factors. In early stages, clinical diagnosis is often difficult and distinguishing HCC from cirrhosis and other hepatic masses by conventional tests is frequently not feasible. Physicians usually depend on measuring serum alpha-fetoprotein (AFP), but this marker has low sensitivity and specificity. The aim of this research was to determine any role of serum cytokeratin-18(Ck-18) as a marker for diagnosis of HCC in patients with liver cirrhosis. Patients and methods: We used ELISA to measure the serum levels of AFP and CK 18 in 60 Egyptian patients (30 cirrhotic and 30 with HCC) and 30 controls. Results: The Ck-18 level was significantly elevated in the HCC group (1247.8± 105.3U/L) when compared to the liver cirrhosis (834.1± 38.8 U/L) and control groups (265.2±83.1U/L). Ck-18 as a marker showed 95.6% sensitivity, 93.3% specificity and 98.8% accuracy. The mean serum AFP was 4901.4±2185.8ng/ml in the HCC group, 100.7±71.7 ng/ml in the cirrhotic group, and 4.0±1.2ng/ ml in controls. AFP showed 55. 7% sensitivity, 97. 7% specificity and 84.4% accuracy. Combined use of both Ck-18 and AFP improved the sensitivity to 98%. Conclusion: Serum cytokeratin-18 level can be used as a diagnostic biomarker for HCC with a higher sensitivity than AFP.     

Serological AFP/Golgi protein 73 could be a new diagnostic parameter of hepatic diseases

We have investigated the changing rule of serum form of GP73 (sGP73) in different hepato-pathologic processes and identified the sGP73 role in inflammation, fibrosis and carcinogenesis since sGP73 has been regarded as a candidate tumor marker. Quantitative enzyme-linked immunosorbent assay detected sGP73 in 535 subjects with hepatocellular carcinoma (HCC), liver cirrhosis (LC), hepatitis, focal nodular hyperplasia (FNH), angioma, intra-hepatic cholangio-carcinoma (ICC) and metastatic cancer from adenocarcinomas (MC). Median sGP73 in LC was higher than in HCC and hepatitis (p = 0.001), and sGP73 in all three groups were higher than those in healthy individuals (p < 0.001); sGP73 in LC patients with Child-Pugh class A was lower than in class B and C (p = 0.001), no significant difference was found between early and advanced HCC groups (110.4 μg/L vs. 102.8 μg/L). AFP/GP73 had a sensitivity of 75.8% and specificity of 79.7% with an area under the receiver operating curve (AUROC) of 0.844 vs. 0.812 for AFP (p = 0.055) with a sensitivity of 95.2% and specificity of 47.1%; in detecting early HCC, AUROC of AFP/GP73 was 0. 804 vs. 0.766 for AFP (p = 0.086). sGP73 correlated with AST, AST/ALT, ALB, A/G and ALP in LC. The positive rate of sGP73 in angioma, FNH, ICC, and MC was 0, 50, 63.3, 53.3%, respectively; AFP/GP73 was 0.796 with the sensitivity of 81.4% and specificity of 70.0% when differentiating MC from AFP-negative HCC. Increased sGP73 is related to hepatic impairment and chronic fibrosis, and when combined with AFP could improve the differential diagnosis of hepatic diseases.