血清GPC3、GP73和AFP联合检测在HCC中的临床价值

目的 研究血清磷脂酰肌醇硫酸类肝素蛋白聚糖3（GPC3）、高尔基体蛋白73（GP73）和甲胎蛋白（AFP）联合检测在原发性肝细胞癌（HCC）诊断中的临床价值.方法 用ELISA方法检测60例HCC患者、56例肝硬化患者和50名健康体检者血清GPC3和GP73水平;用微粒子酶免疫分析法（MEIA）测定血清AFP水平.结果 HCC患者的血清GPC3和GP73水平及阳性率均显著高于肝硬化组和正常对照组,差异有统计学意义（P＜0.05）.血清GPC3和GP73水平与AFP水平、HCC病灶大小、门静脉癌栓（PVI）浸润和HBV感染均无相关.AFP联合GPC3或GP73检测诊断HCC的敏感性（73.33％,80.00％）均优于AFP单独检测（53.33％）;GPC3＋ GP73＋ AFP联合检测的约登指数最高（69.69％）,敏感性为86.77％,特异性为83.02％.在AFP阴性的HCC病例中,GPC3和GP73的阳性率均为42.86％.结论 GPC3和GP73可作为新的肿瘤标志物与AFP联合检测,提高血清标志物检测对HCC的诊断率.

The Clinical Value of the Combined Detection of AFP,GPC3 and GP73 in Patients with HCC

Objective To evaluate the clinical value of combined detection of GPC3,GP73 and AFP in patients with HCC.Methods The study included 60 patients with HCC and 56 patients with liver cirrhosis.Fifty healthy volunteers served as control group.Sera of all cases were examined for GPC3 and GP73 by ELISA and correlated its levels with serum AFP level by MEIA.Results The serum expression and positive rates of GPC3,GP73 and AFP were significantly elevated in patients with HCC than those in cirrhotic patients and control group （P ＜ 0.05）.The levels of either GPC3 or GP73 were independent of the size of HCC,PVI,the AFP level and infection of HBV.The sensitivity of combined detection of AFP with GPC3 or GP73 （73.33％,80.00％）was better than that of AFP alone （53.33％）.The combined detection of GPC3,GP73 and AFP maybe the best Youden index,the sensitivity and specificity being 86.77％ and 86.02％,respectively.Either GPC3 or GP73 was detected in 42.86％ of negative HCC for AFP.Conclusion It could be concluded that both GPC3 and GP73 can be considered as additional tumor markers to improve the diagnostic potential of AFP in HCC patients.