血清GP73作为原发性肝癌肿瘤标志物的来源探究  

Serum Golgi protein 73 as a tumor marker in diagnosis of primary hepatic cancer

作　　者：徐少珊[1] 石玉玲[1] 张亚松[1] 孙朝晖[1] 李林海[1] 张伟[2] 陈晓东[2] 陈炳旭[2] 

机构地区：[1]广州军区广州总医院检验科,广州510010 [2]广州军区广州总医院病理科,广州510010

出　　处：《军医进修学院学报》2011年第11期1164-1167,共4页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探究血清GP73作为原发性肝癌的肿瘤标志物的可行性。方法采用SYBR Green qPCR法对103例原发性肝癌(PHC)、13例肝硬化、49例肝炎和50例健康人群外周血单核细胞GP73 mRNA的相对表达量进行检测,同时检测分析8份正常肝组织和8份肝癌组织的GP73 mRNA相对表达水平。对7例病理确诊为PHC的肝组织和1例正常肝组织、1例肝硬化肝组织中GP73的表达进行免疫组化分析。采用ELISA法检测血清GP73水平和利用电化学发光法血清中AFP水平。结果外周血有核细胞GP73 mRNA含量四组间差异无统计学意义(F=3.013,P=0.055)。肝癌组织GP73mRNA表达量(12.64)显著高于正常肝组织(1.00)。GP73免疫组化结果显示,正常肝组织中GP73少量在肝实质细胞胆小管处表达。肝硬化组织中GP73在肝细胞胞浆中弱阳性表达,但在肝细胞胞浆的两侧靠近胆小管位置呈颗粒状浓集;胆管柱状上皮也呈强阳性着色。PHC患者肝组织GP73在肿瘤细胞胞浆呈强阳性着色,且在胆管上皮细胞靠近腔缘一侧呈深棕色颗粒状分布。肝癌组中血清GP73水平显著高于肝炎组及健康对照组(χ2=62.541,P=0.000)。通过ROC曲线确定诊断肝癌的GP73临界值为113.2μg/L,和AFP的临界值为13.3μg/L时,GP73和AFP单项检测的敏感度分别为68.0%和56.3%,特异度分别为94.8%和91.8%。结论 PHC患者血清高表达的GP73可能是在癌变的肝细胞胞浆中合成随后分泌入血。血清GP73在诊断PHC时阳性检出率显著高于AFP,且ROC曲线提示灵敏度和特异度均优于AFP。Objective To investigate the feasibility of using serum Golgi protein 73（GP73） as a tumor biomarker in diagnosis of primary hepatic cancer（PHC）.Methods Relative expression of GP73 mRNA was detected by SYBR Green qPCR in peripheral mononuclear cells from 103 PHC patients,13 cirrhosis patients,49 hepatitis patients,50 healthy persons,and in 8 normal liver tissue samples and 8 hepatic cancer tissue samples.Expression of GP73 in 7 liver tissue samples from patients with PHC diagnosed by pathology,1 normal liver tissue sample,and 1 cirrhosis liver tissue sample was analyzed by immunohistochemistry.Results No significant difference was found in expression of GP73 mRNA in peripheral mononuclear cells（F=3.013,P=0.055）.However,the expression level of GP73 mRNA was significantly higher in hepatic cancer liver tissue samples than in normal liver tissue samples（12.64 vs 1.00,P〈0.05）.Immunohistochemistry displayed that the GP73 in normal liver tissue samples was expressed in a small number of biliary canaliculi and liver parenchymal cells,while the GP73 in cirrhotic liver tissue samples was slightly expressed in cytoplasm of hepatocytes,which was concentrated in a granular shape near the biliary canaliculi with the biliary epithelial cells strongly stained.The GP73 in cytoplasm of hepatic cancer cells was also strongly stained and concentrated in a deep-brown granular shape near one side of epithelial cells in biliary canaliculi.The serum GP73 level was significantly higher in liver cancer patients than in healthy controls and hepatitis patients（χ2=62.541,P=0.000）.The critical value of GP73 and AFP for the diagnosis of PAP was 113.2μg/L and 13.3μg/L,respectively,according to the ROC curves,with a sensitivity of 68.0% and 56.3% and a specificity of 94.8% and 91.8%,respectively.Conclusion High expression level of GP73 in serum of PHC patients may result from its synthesis in cytoplasm of hepatocytes and secretion into blood circulation.The positive serum GP73 rate is significantly higher than that of AF

关 键 词：高尔基体蛋白73 荧光定量PCR 免疫组化 甲胎蛋白 

分 类 号：R446.6[医药卫生—诊断学]