血清磷脂酰肌醇蛋白聚糖3蛋白测定在肝细胞癌诊断中的价值

目的检测血清中磷脂酰肌醇蛋白聚糖3(Glypican-3,GPC3)的浓度,探讨其对原发性肝细胞癌(HCC)的诊断价值。方法用酶链免疫吸附试验(ELISA)对67例HCC患者、41例肝硬化患者、30例健康者血清中GPC3进行测定,化学发光法检测甲胎蛋白(AFP)。结果 HCC患者血清GPC3平均浓度为(10.85±0.58)μg/L;肝硬化患者血清GPC3平均浓度为(2.45±0.61)μg/L;健康者血清GPC3平均浓度为(1.14±0.22)μg/L。HCC患者血清GPC3浓度明显高于肝硬化患者和健康者(H=327.000,P=0.0001),肝硬化患者与健康者差异无统计学意义(Z=0.792,P=0.429)。当以3μg/L为诊断界值时,GPC3对HCC的敏感性和特异性分别为88.1%和85.9%。当AFP以20μg/L为诊断界值时,其对HCC的敏感性和特异性分别为65.7%和76.2%。GPC3对HCC的敏感性显著高于AFP(χ2=10.995,P=0.001)。在23例AFP阴性的HCC患者中有17例GPC3阳性,阳性率为73.9%(17/23)。GPC3的ROC曲线下面积大于AFP(0.898vs0.814)。结论血清GPC3对HCC有很高的敏感性和特异性,可作为一种新的肿瘤标志物用于HCC的诊断。

Diagnostic value of serum Glypican-3 for hepatocellular carcinoma

Objective To detect the concentration of Glypican-3 （GPC3） protein in serum and to explore its diagnostic value for hepatocellular carcinoma（HCC）. Methods The concentration of serum GPC3 in 67 HCC patients, 41 patients with liver cirrhosis and 30 healthy subjects controls were detected by Enzyme-linked immunos-orbent assay（ELISA）. Serum alpha-fetoprotein（AFP） level was detected by chemilum-inesence immunoassay. Results The mean concentration of serum GPC3 was （10.85 ± 0.58） μ g/L, （2.45 ± 0.61） μ g/L and （1.14 ± 0.22） μ g/L in HCC patients, liver cirrhosis patients and healthy subjects. The concentration of serum GPC3 protein in HCC patients was markly higher than in liver cirrhosis patients and healthy subjects（H=327.000, P=-0.0001）, but there was comparable between liver cirrhosis patients and healthy subjects （Z=0.792, P=-0.429）. At a cut off value of 3 μ g/L, the diagnostic sensitivity and specifity of GPC3 for HCC were 88.1% and 85.9%, respectively. And at a cut off value of 20 μ g/L, the diagnostic sensitivity and specifity of AFP for HCC were 65.7% and 76.2%, respectively. The sensitivity of GPC3 was significantly higher than that of AFP（X^2=10.995, P=0.001）. In the 23 HCC patients whose AFP〈20 μg/L, the positive rate of GPC3 protein was 73.9% （17/23）. The surface area under ROC curve of GPC3 was larger than that of AFP （0.898 vs 0.814）. Conclusions Serum GPC3 is highly sensitive and specific for detecting HCC. It can be used as a new marker for the diagnosis of HCC.