血清GP73联合AFP在肝细胞癌诊断中的价值

目的 探讨血清高尔基体蛋白73（GP73）与甲胎蛋白（AFP）联合检测在肝细胞癌（HCC）诊断中的价值。方法 收集2011年2月至2012年1月30例HCC患者（HCC组）、30例肝硬化患者（肝硬化组）和20例健康人（健康对照组）的血清，分别用酶联免疫吸附法（ELISA）和电化学发光免疫法（ECLIA）检测各组血清中GP73和AFP水平。结果 HCC组、肝硬化组和健康对照组血清GP73水平分别为（251.9±130.2）ng／ml、（74.7±40.6）ng／ml和（12.2±4.0）ng／ml，AFP水平分别为（141.6±158.3）ng／ml、（36.0±35.0）ng／ml和（2.2±1.5）ng／ml。GP73 检测HCC的敏感度为76.7％，特异度82.0％，约登指数58.7％，准确度80.0％。AFP检测HCC的敏感度为63.3％，特异度80.0％，约登指数43.3％，准确度68.8％。两者联合检测的敏感度为86.7％，特异度78.0％，约登指数64.7％，准确度81.3％。结论 HCC患者血清中GP73和AFP水平较高，两者联合检测可以显著提高HCC的诊断能力。

Significance of combined determination of serum GP73 and AFP in the early diagnosis of hepatocellular carcinoma

Objective To investigate the clinical value of combined determination oi serum tumor maker Golgl protein /3 （GP73） and alpha -fetoprotein （AFP） in the diagnosis of hepatocellular carcinoma（HCC）. Methods Serums of 30 HCC patients, 30 liver cirrhosis and 20 healthy controls were collected from Feb. 2011 to Jan. 2012. Serum GP73 and AFP levels were determined by ELISA method and ECLLA method respectively. Results Serum GP73 levels in the HCC, liver cirrhosis and healthy groups were （251.9 -＋ 130. 2 ） ng/ml, （ 74. 7 _＋ 40. 6） ng/ml and （ 12. 2 -＋ 4. 0） ng/ml respectively, and AFP were （ 141.6 -＋ 158.3 ） ng/ml, （ 36. 0 -＋ 35. O） ng/ml and （2. 2 _＋ 1.5 ） ng/ml respectively. Serum GP73 and AFP levels in HCC group were higher than those of non - HCC groups（ P 〈 O. 05 ）. The sensitivity of GP73 in detection was 76. 7%, specificity was 82, 0%, Youden index was 58. 7% and total matching ratio was 80. 0%. The sensitivity of AFP was 63.3% , specificity was 80. 0% , Youden index was 43.3% and total matching ratio was 68.8%. Combined detection of the two parameters could improve the sensitivity up to 86. 7% and Youden index to 64. 7% and total matching ratio to 81.3%, then maintain a high specificity of 78.0%. Conclusion GP73 and AFP are highly expressed in the serum of the patients with HCC. Combined determination of serum GP73 and AFP can improve HCC diagnostic performance.