血清GP73及其它5种血清学标志物对原发性肝癌的诊断价值探讨  

Diagnosis Evaluation of Primary Hepatocellular Carcinoma by Combined Determination of Golgi Protein 73 and Other Five Serum Markers

作　　者：徐炜烽 高国生[2] 祝成亮[3] 徐晓珍[2] 胡耀仁[2] 翁彭剑[2] 

机构地区：[1]宁波市李惠利医院,浙江宁波315041 [2]宁波市第二医院,浙江宁波315010 [3]武汉大学人民医院,湖北武汉430060

出　　处：《中华中医药学刊》2012年第12期2635-2637,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目(2012CB518900);国家自然科学基金资助项目(81101485);吴阶平医学基金会肝病实验诊断研究基金(LDWMF-SY-2011C004);宁波市医学科技计划项目(2010A02)

摘　　要：目的:探讨血清高尔基体蛋白73(Golgi protein 73,GP73)及AFP、ALP、GGT、LAP、AFU等血清学标志物单项和联合检测对原发性肝癌(PHC)的诊断价值。方法:收集32例慢性肝炎、36例肝硬化、57例原发性肝癌(PHC)患者及30名健康体检者的血清,对GP73及AFP、ALP、GGT、LAP、AFU等血清学标志物进行检测,并对检测结果进行统计学分析。结果:Spearman相关分析表明血清GP73与AFP、ALP、GGT、LAP、AFU均有一定的相关性(均P<0.05)。GP73、AFP、ALP、GGT、LAP、AFU在疾病组(包括慢性肝炎组、肝硬化组、PHC组)和正常对照组中的总体差异均有统计学意义(均P<0.05),疾病组血清水平均高于正常对照组;疾病组中又以PHC患者最高,GP73的血清水平均显著高于其他组(均P<0.05)。通过logistic回归对上述指标构建新的预测模型,新的预测因子的AUC虽然高于其它单项指标,但与GP73的差异不大(P>0.05),且这两者的AUC均显著高于其它5种血清学标志物(P<0.05)。结论:GP73单项检测对PHC有较好的诊断作用,GP73联合AFP、AFU、GGT、LAP、ALP检测对提高诊断效能帮助不大,GP73是潜在的有可能取代AFP的诊断PHC的重要血清标志物。Objective：To explore the clinical diagnosis and combined diagnosis values of Golgi protein 73 （GP73）and alpha - fetoprotein （ AFP）, Alkaline phosphatase （ ALP）, Gamma - glutamyl transpeptidase （ GGT）, Leucine Aminopeptid- ase （ LAP）, a - L - t＇ucosidase （AFU） for primary hepatocellular carcinoma （ PHC ）. Methods ： The serum GP73 and AFP, ALP, GGT, LAP and AFU were detected by enzyme - linked immunosorbent assay and microparticle chemiluminescent im munoassay in patients（32 hepatitis .36 cirrhosis and 57 primary he^atocellular carcinoma ） and 30 healthy controls. Then a statistical analysis was made on these results. Results：There were some correlations between the serum GP73 and AFP, ALP, GGT, LAP and AFU by spearman correlation analysis （ all P 〈 0.05 ）. The difference of GP73, AFP, ALP, GGT, LAP and AFU had statistical significance between the patients and healthy controls（ all P 〈 0.05 ）. The serum levels of the pa- tients were significantly higher than those of healthy controls （all P 〈 0.05 ）, and the patients with PHC had the highest se- rum levels, especially the serum GP73 was much higher than that of other patients （ all P 〈 0.05 ）. The area under the curve （AUC） of the new combining predictor established by the logistic model was bigger than the other serum markers, but the difference with GP73 had no statistical significance （ P 〉 0.05 ）. Meanwhile , the area under the curve （ AUC ） of the new combining predictor and GP73 was much bigger than that of the others（ all P 〈0.05）. Conclusions ：The detection of serum GP73 is helpful in the diagnosis of PHC, but combined determination of CP73 and AFP, ALP, GGT, LAP and AFU can not improve the diagnosis efficiency. Serum GP73 can become a potential important PHC tumor marker, which may substitute for AFP .

关 键 词：原发性肝癌 高尔基体蛋白73 ROC曲线 

分 类 号：R735.7[医药卫生—肿瘤]