血清高尔基体蛋白73在乙型肝炎相关性肝细胞癌早期诊断中的价值

目的定量检测GP73在乙型肝炎相关性肝脏疾病中的表达,探讨其在乙型肝炎相关性肝细胞癌早期诊断中的价值。方法收集血清标本88例,其中健康人16例,慢性乙型肝炎患者16例,肝硬化患者16例,早期肝细胞癌患者40例,酶联免疫吸附试验（ELISA）检测各组人群中GP73的表达情况,并与AFP进行比较。结果所有肝脏疾病组（肝细胞癌组、肝硬化组及肝炎组）患者血清GP73水平均显著高于健康对照组（P〈0.01或0.05）;肝细胞癌组患者血清GP73水平明显高于肝炎组（P〈0.05）,但与肝硬化组差异无统计学意义;当以104.5ng/ml为截取值时,血清GP73诊断早期肝细胞癌的敏感度为67.5%,特异度为81.3%,与本研究中AFP的敏感度（47.5%）相比显著提高。GP73诊断早期肝细胞癌的ROC曲线下面积（AUROC）为0.81。结论血清GP73在以乙型肝炎为基础的原发性肝细胞癌中的早期诊断价值优于AFP,但在与肝硬化鉴别诊断中的价值有待于进一步探讨。

Value of serum GP73 on early diagnosis of hepatocellular carcinoma based on hepatitis B

Objective To quantify the levels of serum GP73 in patients with liver diseases and validate serum GP73 as a biomarker for diagnosis of early hepatocellular carcinoma based on hepatitis B. Methods Enzyme-linked immunosorbent assay （ELISA） was applied to measure serum GP73 during 72 patients with liver diseases and 16 healthy individuals. Results Serum GP73 levels were significantly higher in patients with liver disease （HCC, cirrhosis, hepatitis） compared with healthy individuals （P 〈 0.01 or P 〈 0.05 ） ; GP73 in early HCC patients were not sinificantly higher than that in cirrhosis patients; When serum GP73 was applied to diagnose early HCC, the sensitivity was 67.5% and the specificity was 81.3% at the optima cut-off value of 104.5 ng/ml. The area under the receiver-operating characteristic curve （ AUROC） was 0.81. Conclusions Serum GP73 is better than AFP for the diagnosis of early HCC, which can be used as biomarker in early HCC diagnosis.