AFP、APF-L3、GP73、AFP-mRNA联合检测在肝细胞癌诊断中的应用价值  

The application value of combined detection for serum alpha-fetoprotein,alpha-fetoprotein-L3,Golgi protein 73 and AFP-mRNA in the diagnosis of hepatocellular carcinoma

作　　者：李永勤[1] 陈浩[1] 耿坤静 杜博勋 裘银久[1] 

机构地区：[1]河北省保定市传染病医院,071000

出　　处：《河北医药》2012年第5期648-650,共3页Hebei Medical Journal

摘　　要：目的探讨甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体蛋白(GP73)及AFP-mR-NA联合检测在HCC诊断中的价值。方法收集175例血清、其中肝细胞癌患者73例(HCC组)、肝硬化患者41例(肝硬化组)、慢乙肝患者36例(慢性肝炎组)、正常人25例(正常人组),采用酶联免疫法检测GP73,用化学发光法检测AFP,用亲和吸附离心法检测AFP-L3,采用荧光定量逆转录聚合酶链反应(RT-PCR)法检测患者AFP-mRNA外周血的表达。结果 AFP、AFP-L3、GP73及AFP-mRNA在HCC组的含量与肝硬化组和正常组比较差异有统计学意义(P<0.01),通过ROC曲线评价,AFP、AFP-L3、GP73及AFP-mRNA的曲线下面积分别为0.691、0.859、0.816、0.762,敏感度分别为54.79%、76.71%、80.82%、53.42%,特异度分别为79.41%、95.10%、82.35%、99.02%,四者联合检测的ROC曲线下面积为0.958,联合检测的敏感度明显提高达95.8%,特异度为95.0%。结论 AFP、AFP-L3、GP73及AFP-mRNA四者联合检测可显著提高肝细胞癌诊断的灵敏度和特异度。优于AFP、AFP-L3、GP73和AFP-mRNA的单项检测。Objective To investigate the application value of combined detection for alpha fetoprotein （AFP）, alpha-fetoprotein-L3 （ AFP-L3 ）, Golgi protein 73 （ GP73 ） and AFP-mRNA in the diagnosis of hepatocellular carcinoma （HCC）. Methods Enzyme-linked immunosorbent assay （ELISA） was used to detect the serum levels of GP73 in 73 cases of HCC,41 cases of liver cirrhosis,36 cases of chronic hepatitis B and 25 healthy subjects. AFP was detected by chemiluminescent immunoassay, and AFP-L3 was determined by adsorption centrifuging. AFP-mRNA was tested by fluorescent quantitative RT-PCR. Results There were significant differences in the levels of AFP, AFP-L3, GP73, AFP-mRNA between HCC group and cirrhosis group, normal control group （ P 〈0. O1 ）. The areas evaluated according to ROC curves were O. 691 （AFP）,0. 859 （APF-L3）, O. 816 （GP73）,0.762 （AFP-mRNA） respectively in HCC group, and the sensitivities were 54.79% ,76.71%, 80.82% ,53.42%, respectively, and specificities were 79.41%, 95.10%, 82.35%, 99.02%, respectively. The areas under ROC curves for the four tumor-related markers were O. 958 by combined detection. The sensitivity of combined detection was significantly increased, which reached 95.8%, and its specificity was 95.0% in the diagnosis of HCC. Conclusion The combination detection for AFP, AFP-L3,GP73 and AFP-mRNA can obviously enhance the sensitivity and specificity in the diagnosis of HCC, which is superior to individual detection of AFP, AFP-L3, GP73 or AFP-mRNA.

关 键 词：甲胎蛋白异质体 高尔基体蛋白 AFP-mRNA肝细胞癌 联合检测 

分 类 号：R735.7[医药卫生—肿瘤]