血清GP73及AFP-L3检测在原发性肝癌诊断中的意义

目的探讨高尔基体蛋白73(GP73)及甲胎蛋白异质体(AFP-L3)在原发性肝癌(PHC)诊断中的应用价值。方法分别采用酶联免疫吸附试验和亲和吸附法法检测68例PHC患者、42例肝硬化患者以及40例健康体检者血清GP73以及AFP-L3的含量,计算AFP-L3占总AFP的比率。结果检测血清GP73诊断PHC的临界值为123.8μg/L,曲线下面积为0.909,95%可信区间为0.835～0.957,诊断灵敏度为72.1%,特异度为91.4%;血清AFP-L3诊断PHC临界值为10.53%,曲线下面积0.885,95%可信区间为0.826～0.940,诊断灵敏度为70.6%,特异度为93.9%;PHC组血清GP73及AFP-L3含量明显高于肝硬化组及对照组(P<0.05)。与GP73及AFP-L3单项检测比较,二者联合检测可明显提高PHC诊断的灵敏度、阴性预测值以及总有效率(P<0.05),而特异度和阳性预测值无显著性差异(P>0.05)。结论 GP73及AFP-L3含量在PHC患者血清中明显增高,且二者联合检测可提高PHC诊断效率,可作为PHC诊断的血清标志物。

Diagnostic significance of combined application of serum GP73 and AFP-L3 in patients with PHC

Objective To investigate the clinical significance of combined application of serum Golgi protein 73 （GP73） and alpha-fetoprotein variant （AFP-L3） in patients with primary hepatic carcinoma （PHC） . Methods Total 150 subjects were recruited,including 68 patients with PHC,42 patients with liver cirrhosis and 40 healthy controls. Serum levels of GP73 and AFP-L3 were determined by ELISA and affinity-absorbent assay,respectively. Results The critical value of GP73 was 123. 8 ？ g/L. The area under curve （AUC） was 0. 909. The 95% confidence interval （CI） was 0. 835-0. 957. The sensitivity of GP73 was 72. 1% ,and the specificity was 91. 4% . The critical value was 70. 6% ,and the specificity was 93. 9% . The serum levels of GP73 and AFP-L3 in patients with PHC were significantly higher than that in patients with cirrhosis and healthy controls （P〈0. 05） . Compared with single GP73 or AFP-L3,there were significant difference in the sensitivity,negative predictive value and total efficiency （P〈0. 05） ,but no significant difference in specificity and positive predictive value（P〈0. 05） . Conlusion The serum levels of GP73 and AFP-L3 were high in patients with PHC. At the same time,the combined application of serum GP73 and AFP-L3 can increase the diagnostic efficiency for PHC,which can be a good diagnostic marker for PHC.