血清甲胎蛋白、γ-谷氨酰转肽酶Ⅱ、高尔基体蛋白73检测在原发性肝癌早期诊断中的价值  

Values of serum AFP,GGTⅡ and GP73 in diagnosis of primary hepatocellular carcinoma

作　　者：朱陈[1] 孙源源[1] 金燕[1] 

机构地区：[1]江苏省南通市第三人民医院消化内科,江苏南通226000

出　　处：《临床肝胆病杂志》2014年第10期1064-1066,共3页Journal of Clinical Hepatology

摘　　要：目的探讨血清甲胎蛋白(AFP)、γ-谷氨酰转肽酶(GGT)Ⅱ、高尔基体蛋白73(GP73)对于原发性肝癌患者的早期诊断价值。方法抽取2013年2月至2014年2月在南通市第三人民医院进行治疗的100例肝病患者(50例肝炎及肝硬化患者为肝脏良性病变组,50例原发性肝癌患者为原发性肝癌组)和50例正常体检者血清,分别利用电化学发光法、特异免疫膜吸附法、酶联免疫吸附法检测血清中的AFP、GGTⅡ、GP73水平。计量资料多组间比较采用方差分析,两两比较采用q检验;对单项及联合检测结果作图绘成受试者工作特征曲线(ROC曲线),计算曲线下面积(AUC),观察AFP、GGTⅡ、GP73单独和联合检测的AUC、敏感度、特异度。结果血清GGTⅡ水平在对照组或肝脏良性病变组、原发性肝癌组的两两比较中差异均有统计学意义(P值均<0.05),但是对照组与肝脏良性病变组差异没有统计学意义(P值均>0.05)。AFP和GP73水平在原发性肝癌组、肝脏良性病变组,对照组的两两比较中差异均有统计学意义(P值均<0.05)。单独检测时GP73的特异度为69%,敏感度为92%;GGTⅡ的特异度为64%,敏感度为84%;AFP的特异度为51%,敏感度为76%。联合检测特异度为94.6%,敏感度为98.8%。结论单独检测时GP73指标最好,3个指标联合检测,诊断原发性肝癌的特异度及灵敏度均提高。Objective To explore the early diagnostic values of serum alpha -fetoprotein （AFP）,gamma -glutamyltransferase Ⅱ （GGTⅡ）,and Golgi protein 73 （GP73）in patients with primary hepatocellular carcinoma （PHC）.Methods The serum specimens of 100 pa-tients with liver diseases （50 cases of hepatitis and liver cirrhosis and 50 cases of PHC）and 50 healthy people were collected in our hospital from February 2013 to February 2014.Electrochemical luminescence technique,specific immuno -membrane adsorption assay,and enzyme-linked immunosorbent assay were used to measure the serum levels of AFP,GGTⅡ,and GP73.Comparison of continuous data between multiple groups was made by analysis of variance,and comparison between two groups was made by q test.The receiver operating character-istic （ROC）curves of single or combined test results were made,and the areas under the ROC curves （AUCs）were calculated.The sensi-tivity,specificity,and AUCs of AFP,GGTⅡ,GP73,and the combined test were analyzed and compared.Results The level of serum GGTⅡ in the PHC group was significantly different compared with those in the other two groups （F =16.224,P 〈0.05）,but there was no significant difference between the normal group and the hepatitis and liver cirrhosis group （P 〉0.05）.Significant differences in serum levels of AFP and GP73 were observed by paired comparison between the PHC group,hepatitis and liver cirrhosis group,and normal group （F =193.128,F =20.231,P 〈0.05 for both）.When assayed alone,the specificities of GP73,GGTⅡ,and AFP were 69%,64% and 51%, respectively,and the sensitivities were 92%,84%,and 76%,respectively.In combined test,the specificity was 94.6% and the sensitivi-ty was 98.8%.Conclusion The GP73 test is the best performer in the single assays.Combined test of serum AFP,GGTⅡ,and GP73 shows a good diagnostic value for PHC with greatly improved specificity and sensitivity.

关 键 词：肝肿瘤 早期诊断 甲胎蛋白类 Γ-谷氨酰转移酶 高尔基体蛋白 73 

分 类 号：R735.7[医药卫生—肿瘤]