磷脂酰肌醇蛋白聚糖3与甲胎蛋白异质体及总胆汁酸在原发性肝癌中的表达及其诊断意义

目的探讨联合检测磷脂酰肌醇蛋白聚糖3（GPC3）、甲胎蛋白异质体（AFP-L3）和总胆汁酸（TBA）在原发性肝癌诊断中的临床意义。方法收集2011年5月至2012年12月确诊的原发性肝癌患者154例（肝癌组），肝硬化患者78例（肝硬化组），健康体检者56例（对照组），用酶联免疫吸附试验法分别检测GPC3、AFP—L3水平，用放射免疫法检测甲胎蛋白（AFP）水平，用循环酶法检测TBA水平，并进行比较。结果肝癌组GPC3、AFP—L3、TBA水平分别为（10．70±3．10）μg／L、（338．60±379．20）μg／L、（79．91±70．64）μmol/L，明显高于肝硬化组的（2．70±0．71）μg／L、（6．45±2．79）μg/L、（33．10±21．90）μmol／L和对照组的（1．28±0．60）μg／L、（0．684-0．56）斗g／L、（5．40±2．20）μmol／L，肝硬化组GPC3、AFP—L3、TBA水平明显高于对照组，差异均有统计学意义（P〈0．01）。三项联合检测的灵敏度为97．2％（280／288），明显高于单项测定GPC3（72．1％，111／154）、AFP．L3（53．2％，82／154）、TBA（94．8％，146／154）的灵敏度，差异有统计学意义（P〈0．01）。结论血清GPC3、AFP．L3和TBA联合检测明显提高原发性肝癌检测的灵敏度，对原发性肝癌的早期诊断有重要的临床意义。

The expression and diagnostic significance of phosphatidylinositol 3 proteoglycans and alpha- fetoprotein heterogeneity and total bile acids in primary hepatoceilular carcinoma

Objective To evaluate the clinical significance of combined detection of phosphatidylinositol 3 proteoglycans （GPC3） and alpha-fetoprotein heterogeneity （AFP-L3） and total bile acids （TBA） in diagnosis of primary hepatocellular carcinoma. Methods Collected 154 cases of primary hepatocellular carcinoma patients （hepatocellular carcinoma group） and 78 cases of cirrhosis patients （cirrhosis group） and 56 normal controls （control group） from May 2011 to December 2012. The level of GPC3, AFP-L3 was measured by enzyme-linked immunosorbent assay, the level of alpha-fetoprotein （AFP） was determined by radioimmunoassay, and the level of TBA was measured by enzymatic cycle, and they were compared. Results The level of GPC3,AFP-L3 and TBA was （10.70 ± 3.10） IXg/L, （338.60 ± 379.20） IX g/L, （79.91 ± 70.64） μ mol/L in hepatocellular carcinoma group ,which was higher than that in cirrhosis group （2.70 ± 0.71 ） μ g/L, （6.45 ± 2.79） IX g/L, （33.10 ± 21.90） μ mol/L] and control group （ 1.28 ± 0.60） μ g/L, （0.68 ± 0.56） μ g/L, （5.40 ± 2.20） μ mol/L], the level of GPC3 ,AFP-L3 and TBA in cirrhosis group was higher than that in control group,and there was significant difference （P〈 0.01 ）. The sensitivity of three tumor markers combined detection was 97.2% （280/288）, which was significantly higher than that of individual detection of GPC3 （72.1%, 111/154）,AFP-L3 （53.2% ,82/154）, TBA （94.8%, 146/154）, the difference was statistically significant （P 〈 0.01 ）. Conclusion Serum GPC3 ,AFP-L3 and TBA combined detection can improve the sensitivity of primary hepatocellular carcinoma and has important clinical significance in early diagnosis of primary hepatocellular carcinoma.