高尔基体蛋白73与AFP在原发性肝细胞癌筛查中的应用对比研究

目的对比高尔基体蛋白73(GP73)与AFP作为原发性肝细胞癌(HCC)筛查血清标记物的效果。方法收集2012年中山市肿瘤研究所对中山市小榄镇35⁶4岁年龄段的居民实施HCC筛查血清标本并收集临床HCC初治患者血清标本,分为5组:正常人群组95例,低危人群组100例,高危人群组95例,筛查HCC组9例,临床HCC组52例。对5组患者检测AFP及GP73,对二者诊断的敏感度、特异度及准确度进行比较。结果 GP73曲线下面积(AUROC)0.759(95%CI:0.68364岁年龄段的居民实施HCC筛查血清标本并收集临床HCC初治患者血清标本,分为5组:正常人群组95例,低危人群组100例,高危人群组95例,筛查HCC组9例,临床HCC组52例。对5组患者检测AFP及GP73,对二者诊断的敏感度、特异度及准确度进行比较。结果 GP73曲线下面积(AUROC)0.759(95%CI:0.683⁰.836),敏感度为72.1%,特异度为63.1%,最佳临界点为98.60 ng/L。AFP的AUROC为0.857(95%CI:0.7920.836),敏感度为72.1%,特异度为63.1%,最佳临界点为98.60 ng/L。AFP的AUROC为0.857(95%CI:0.792⁰.992),敏感度为59.0%,特异度为76.0%,最佳临界点为20.40 ng/L。GP73联合AFP检测,灵敏度为86.9%,特异度为98.3%,AUROC为0.926(95%CI:0.8750.992),敏感度为59.0%,特异度为76.0%,最佳临界点为20.40 ng/L。GP73联合AFP检测,灵敏度为86.9%,特异度为98.3%,AUROC为0.926(95%CI:0.875⁰.976)。结论 GP73准确度低于AFP,灵敏度高于AFP,因此应用于HCC筛查有其独特优势;GP73和AFP联合检测可提高HCC筛查效果。

GP73 versus AFP in screening of the primary hepatocellular carcinoma

Objective To evaluate the effective of the Golgi glycoprotein 73 and AFP as a serum marker in screening of the primary hepatocellular carcinoma（HCC）.Methods Serum sample were collected from the HCC screening pool and the first diagnosed HCC patients, 5 group were identified as follows： population at normal condition （95 cases）, population at low risk （100 cases）, population at high risk （95 cases）, population with screening HCC （9 cases） and population who first diagnosed as HCC （52 cases）. The ELISA was used to detect the serum level of the GP73 and the AFP in five groups. Identify its sensitivity and specificity as the serum biomarker of the HCC diagnose.Results Based on HCC diagnose, the area under ROC curve （AUROC） of GP-73 was 0.759 （95%CI： 0.683-0.836）, the optimal cut-off value was 98.60 ng/L, the sensitivity was 72.1%, the specificity was 63.1%; AUROC of AFP was 0.857（95%CI： 0.792-0.992）, the optimal cut-off value was 20.40 ng/L, the sensitivity was 59.0%, the specificity was 76.0%. Combine GP73 with AFP, the AUROC was 0.926 （95%CI： 0.875-0.976）, the sensitivity was 86.9%, the specificity was 98.9%.Conclusion Despite the accuracy less than the AFP, the sensitivity of GP73 is higher than AFP. This suggests that GP73 has potential when used as a screening serum biomarker.