血清高尔基体蛋白73、异常凝血酶原、磷脂酰基醇蛋白聚糖-3和甲胎蛋白联合检测对原发性肝癌的早期诊断价值研究  

Clinical Significance of Serum GP73,DCP,GPC-3 and AFP Tests in Diagnosis of Primary Hepatic Carcinoma

作　　者：赵运胜[1] 王猛[1] 李军良[1] 吴侠[1] 李洪臣[1] 

机构地区：[1]河北省秦皇岛市第一医院检验科,066000

出　　处：《中国全科医学》2012年第32期3730-3733,共4页Chinese General Practice

摘　　要：目的探讨血清高尔基体蛋白73(GP73)、异常凝血酶原(DCP)、磷脂酰基醇蛋白聚糖-3(GPC-3)和甲胎蛋白(AFP)联合检测对原发性肝癌(PHC)的早期诊断价值。方法选择2011年4—9月在我院就诊的消化系统疾病患者共110例,根据患者疾病分为PHC组50例、慢性肝炎组20例、肝硬化组20、其他消化系统恶性肿瘤组(其他肿瘤组)20例。选择同期我院健康体检正常者20例为对照组。采用酶联免疫法检测各组血清GP73、DCP、GPC-3水平,电化学发光法测定AFP水平。评价各指标单独和联合检测对早期PHC的诊断价值。结果各组血清GP73、DCP、GPC-3和AFP水平比较,差异均有统计学意义(P<0.05)。GP73、DCP、GPC-3和AFP诊断早期PHC的曲线下面积(AUG)分别为0.824〔95%CI(0.735,0.912)〕、0.640〔95%CI(0.533,0.746)〕、0.635〔95%CI(0.527,0.743)〕和0.668〔95%CI(0.564,0.773)〕。将慢性肝炎组、肝硬化组、其他肿瘤组及对照组合并为非PHC组,与PHC组进行比较:单项检测以GP73灵敏度和准确率最高,以GPC-3特异度最高;联合检测以GP73/AFP灵敏度和准确率最高,系列试验中GP73与其他任何一项或几项指标联合的特异度均可达100.0%。结论单独检测GP73对早期PHC诊断价值优于AFP,单独检测DCP或GPC-3对早期PHC有一定的鉴别诊断价值,与AFP相当,GP73、DCP、GPC-3和AFP联合检测对早期PHC有较好的诊断价值,可根据临床实际选择不同的项目组合。Objective To investigate the clinical value of serum Glogi glycoprotein 73（GP73）,des-γ-carboxy prothrombin（DCP）,glypican-3（GPC-3）and alpha-fetoprotein（AFP）tests for early diagnosis of primary hepatic carcinoma（PHC）.Methods Totally 50 cases of PHC（PHC group）,20 cases of chronic hepatitis（CH group）,20 cases of liver cirrhosis（LC group）,20 cases of malignant tumors of digestive system except hepatic carcinoma（DS group）,and 20 cases of healthy controls（control group）were enrolled in this study.Serum GP73,DCP,and GPC-3 levels were detected using enzyme-linked immunosorbent assay.AFP was detected by electrochemiluminescence reaction.Results The serum GP73,DCP,GPC-3,and AFP levels were significantly different among these five groups.The area under curve（AUC）of GP73,DCP,GPC-3,and AFP for diagnosing the early PHC was 0.824（95%CI（0.735,0.912））,0.640（95%CI（0.533,0.746））,0.635（95%CI（0.527,0.743））,and 0.668（95%CI（0.564,0.773））.Comparison between the non-PHC group（including the CH group,LC group,DS group,and control group）and PHC group showed that GP73 had the highest sensitivity and accuracy and GPC-3 had the highest specificity.When applied in a combined manner,GP73/AFP had the highest sensitivity and accuracy.During the consequent tests,GP73,when used consequently with other tests,yielded a specificity of 100.0%.Conclusion When used alone,GP73 has superior diagnostic value than AFP for early PHC.Either DCP or GPC-3 has similar value as AFP for the differential diagnosis of early PHC.The combined GP73,DCP,GPC-3,and AFP tests has good diagnostic value for early PHC,and can be applied based on the specific clinical conditions.

关 键 词：肝肿瘤 高尔基体蛋白73 异常凝血酶原 磷脂酰基醇蛋白聚糖类 甲胎蛋白类 

分 类 号：R735.7[医药卫生—肿瘤]