磷脂酰肌醇蛋白聚糖3与甲胎蛋白异质体在原发性肝癌中的表达及诊断意义  

The expression and diagnostic significance of glypican-3 and AFP heterogeneity in primary hepatocellular carcinoma

作　　者：张宏[1] 叶迎宾 李淑敏[1] 张志涛[1] 李强[1] 

机构地区：[1]河北省邯郸市传染病医院检验科,056002

出　　处：《河北医药》2013年第9期1298-1300,共3页Hebei Medical Journal

摘　　要：目的探讨甲胎蛋白异质体(AFP-L3)和磷脂酰肌醇蛋白聚糖3(GPC3)联合检测对诊断原发性肝癌(PHC)的意义。方法收集确诊的PHC患者100例(PHC组),肝硬化患者50例(肝硬化组),正常对照50例(对照组)。用酶联免疫法分别测出AFP-L3、GPC3的浓度,用放射免疫法测出AFP的浓度,分别按照检测项目统计分析。结果 PHC组与肝硬化组和对照组比较,GPC3和AFP的检测值差异有统计学意义(P<0.01)。肝硬化组与对照组比较,GPC3、AFP的检测值差异有统计学意义(P<0.01)。PHC组的AFP-L3阳性率明显高于肝硬化组和正常对照组(χ2=65.147、88.043,P<0.01);肝硬化组阳性率与正常对照组差异有统计学意义(χ2=4.432,P<0.05)。PHC组GPC3阳性率明显高于肝硬化组和对照组(χ2=88.500、100.780,P<0.01);肝硬化组阳性率与对照组差异无统计学意义(χ2=2.3437,P>0.05)。AFP-L3、GPC3两者联合检测时,诊断PCH的敏感度为97.0%(97/100),特异度为90.0%(90/100),准确度为93.5%(187/200),优于任何单项检测的敏感度和准确度。结论 AFP-L3和GPC3联合检测优势互补,从而提高PHC诊断的敏感度、特异度和准确度。Objective To investigate the significance of combined detection of alpha-fetoprotein-L3（AFP-L3） with glypican-3（GPC3） in diagnosis of primary hepatocellular carcinoma（PHC）.Methods The 100 patients with PHC（PHC group）,50 patients with cirrhosis（cirrhosis group） and 50 healthy subjects（control group） were enrolled in the study.The levels of AFP-L3 and GPC3 were detected by ELISA,and the levels of AFP were detected by radioimmunoassay,and the detection results were statistically analyzed.Results There were significant differences in the levels of GPC3 and AFP between PHC group and cirrhosis group（P〈0.01）,so were between cirrhosis group and control group（P〈0.01）.The positive rate of AFP-L3 in PHC group was significantly higher than that in cirrhosis group or control group（P〈0.01）,and there was a significant difference between cirrhosis group and control group（P〈0.01）.The positive rate of GPC3 in PHC group was significantly higher than that in cirrhosis group or control group（P〈0.01）,however,there was no significant difference between cirrhosis group and control group（P〈0.05）.In the combined detection of AFP-L3 with GPC3 for diagnosis of PCH,the sensitivity,specificity,accuracy were 97.0%（97/100）,90.0%（90/100）,93.5%（187/200）,respectively,which was superior to that of any simple item detection.Conclusion The combined detection of AFP-L3 with GPC3 can enhance sensitivity,specificity and accuracy in diagnosis of PHC.

关 键 词：肝肿瘤 原发性 磷脂酰肌醇蛋白聚糖3 甲胎蛋白 甲胎蛋白异质体 敏感度 特异度 

分 类 号：R735.7[医药卫生—肿瘤]