血清高尔基体蛋白73诊断原发性肝癌价值探讨

目的探讨高尔基体蛋白73（GP73）诊断肝癌的价值。方法在肝癌107例、肝硬化53例、肝衰竭患者40例和健康人34例，采用ELISA法检测血清GP73浓度,采用ROC曲线寻找GP73诊断肝癌的最佳截断点，并与AFP进行比较，以评价GP73诊断肝癌的价值。结果原发性肝癌、肝硬化和慢性肝衰竭患者血清GP73水平分别为123.5±22.4ng/ml、108.9±30.3ng/ml和130.3±45.6ng/ml，均显著高于健康对照人群（44.1±38.9ng/ml，P〈0.05）；原发性肝癌、肝硬化和慢性肝衰竭患者血清AFP水平分别为236.6±205.3ng/ml、5.3±5.56ng/ml和53.9±40.40 ng/ml；选择血清GP73最佳截断点为77.4ng/ml，其诊断原发性肝癌的灵敏度为89.6%，特异度为100%，AFP的最佳截断点为35.4ng/ml，其诊断原发性肝癌的灵敏度为64.2%，特异度为100%；原发性肝癌患者血清GP73水平在不同年龄、性别、Edmondson分级和结节数目多寡之间无显著性相差，而在不同肿瘤大小、TNM分期和是否合并肝硬化方面均有显著性差异（P＜0.05）。结论血清GP73诊断肝癌的灵敏度优于AFP，尤其在AFP阴性患者诊断中有一定的意义。

The diagnostic value of golgi protein 73 in patients with hepatocellular carcinoma

Objective To evaluate the diagnostic value of golgi protein 73 （GP73） in patients with hepato-cellular carcinoma （HCC）. Methods Two hundred hospitalized patients,including 107 cases with HCC,53 cases with cirrhosis and 40 cases with liver failure,and 34 healthy controls were enrolled in this study. Serum GP73 were quantitatively detected by enzyme linked immunosorbent assay. The optimal cut-off value of serum GP73 for HCC diagnosis was determined by the ROC curve and its significance for the diagnosis of HCC was compared with that of serum AFP. Results Serum GP73 in patients with HCC,cirrhosis and liver failure were 123.5±22.35ng/ml,108.9±30.3ng/ml and 130.3±45.6ng/ml,respectively,which were significantly higher than that in healthy controls （44.1±38.9ng/ml,P〈0.05）;Serum AFP in patients with HCC,cirrhosis and liver failure were 236.6±205.3ng/ml,5.3± 5.56 ng/ml and 53.9 ±40.40 ng/ml,respectively;The optimal cut-off value of serum GP73 for HCC diagnosis was 77.4ng/ml,with a sensitivity of 89.6% and a specificity of 100%;Serum GP73 levels were significantly related to tumor sizes,TNM grades and presence of cirrhosis in HCC patients （P〈0.05）,but not to age,gender,Edmondson grades and tumor numbers. Conclusions The sensitivity of serum GP73 as a diagnostic tool for HCC is better than AFP,especially in serum AFP-negative patients with HCC.