血清标志GlyPican-3对肝细胞癌诊断价值初步评价  

Glypican-3,a novel tumor marker in diagnosis of human hepatocellular carcinoma

作　　者：马庆庆[1] 黄建廷 童华波[1] 王凤学[1] 

机构地区：[1]遵义市第一人民医院检验科,贵州遵义563000 [2]青岛市城阳区人民医院麻醉科,山东青岛266109

出　　处：《中华肿瘤防治杂志》2014年第2期127-130,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：贵州省科学技术基金〔黔科合J字(2013)2205号〕;贵州省卫生厅科学技术基金(Gzwkj2011-1-098);贵州省中医药管理局基金(QZYY2012-63)

摘　　要：目的：探讨人血清磷脂酸肌醇蛋白聚糖-3（GlyPican-3）和甲胎蛋白（a—fetoprotein，AFP）联合检测对肝细胞癌（hepatocellularcarcinoma，HCC）诊断的临床价值。方法：收集2011—1l—02-2013—01—13遵义市第一人民医院174例和青岛市城阳区人民医院44例，门诊和肝胆外科人外周血血清218例，其中HCC54例，肝硬化36例，肝炎40例，肝良性肿瘤18例，其他恶性肿瘤40例，健康志愿者30名。双抗体夹心酶联免疫定量测定方法和电化学发光法检测血清中GlyPican-3和AFP的表达水平，结果以中位数（M）表示。制作受试者工作特征（receiveroperatingcharacteristic，ROC）曲线，以曲线下面积（areaundercurve，AUC）反映诊断的准确性。结果：HCC组血清GlyPican-3的表达水平为654．67ρg／mL，显著高于肝硬化组的32．83ρg／mL、肝炎组的33．04ρg／mL、肝良性肿瘤组的15．14ρg／mL、其他恶性肿瘤组的25．82ρg／mL和健康志愿者组的3．90ρg／mL，P值均〈0．001；GlyPican-3组AUC为0．883，95％CI：0．833～0．923；AFP组为0．802，95％CI：0．743～0．853；GlyPican-3和AFP联合检测为0．945，95％CI：0．905～O．971。GlyPican-3和AFP联合检测显著高于单个检测指标，Z值分别为5．944和3．409，P值分别为〈0．001和0．007。GlyPican-3取最佳临界值为60ρg／mL时，GlyPican-3诊断HCC的灵敏度和特异度分别为85．18％（46／54）和73．78％（121／164）；GlyPican-3联合AFP检测诊断HCC的灵敏度可达96．29％（52／54）。血清GlyPican-3的表达水平随HCC的临床分期增加而升高，H=4．571，P=0．025。结论：血清GlyPican-3的表达水平对于HCC具有较高的诊断价值，血清GlyPican-3联合AFP检测可提高HCC的诊断率。血清GlyPican-3的表达水平与，临床分期有关。OBJECTIVE：To explore the clinical value of combined detection of serum human GlyPican-3 and a-feto- protein （AFP） in the diagnosis of hepatoceilular carcinoma. METHODS：The peripheral serum samples from 218 individu- als were collected, including 54 HCC patients, 36 cirrhotic patients, 40 hepatitis patients, 18 patients with benign liver tumor,40 patients with other malignancies, and 30 healthy volunteers. GlyPican-3 levels in the serum were detected by double antibody sandwich ELISA,and AFP levels in serum were detected by the electrochemiluminescence immunoassay. Those results were shown with median level. Accuracy of the diagnosis was evaluated by the area under the receiver oper- ating characteristic curve （ROC-AUC）. RESULTS：The expression level of serum GlyPican-3 from the HCC patients was significantly higher than those from the other patient groups （all, P〈0.05）. AUC was 0. 883 （95 % CI：0. 833-0. 923） for GlyPican-3,0. 802（95%CI：0. 743-0. 853） for AFP,0. 945（95%CI：0. 905-0. 971） for GlyPican-3＋AFP,respectively. AUC was the highest for GlyPican-3 ＋ AFP, significantly greater than both AFP and GlyPican-3 （Z = 5. 944, P = 0. 007 and Z= 3. 409,P= 0. 007）. When the cut-off value was determined as 60 ρg/mL, the sensitivity and specificity of GlyPi- can-3 for the diagnosis of HCC were 85.18% （46/54） and 73.78% （12t/164）. The sensitivity of GlyPican-3 in combina- tion with serum AFP for the diagnosis of HCC was 96. 29% （52/54）. The expression level of serum GlyPican-3 was markedly increased with the increase of clinical stages（H= 4. 571, P= 0. 025）. CONCLUSIONS： The expression level ofserum GlyPican-3 has a high diagnostic value for HCC patients. The rate of HCC diagnosis is increased by combined exam- ination of serum GlyPican-3 and AFP. The expression level of serum GlyPican-3 in HCC is related fo the clinical staging.

关 键 词：磷脂酸肌醇蛋白聚糖-3 甲胎蛋白 肝细胞癌 血清学 诊断 

分 类 号：R735.7[医药卫生—肿瘤]