血清磷酯酰肌醇蛋白聚糖3与高尔基体蛋白73检测在肝细胞癌诊断中的意义  

Clinical study of phosphatidylinositol proteoglycan 3 and Golgi protein 73 on screen of early hepatocellular carcinoma

作　　者：经继生 汪顺才[1] 马洁[2] 朱梦琪[3] 马久明[1] 周华[1] 虞腊青 杨永峰[4] 

机构地区：[1]江苏省句容市人民医院感染科,212400 [2]江苏大学基础医学和医学技术学院 [3]复旦大学附属华山医院 [4]南京市第二医院

出　　处：《肝脏》2014年第11期844-846,共3页Chinese Hepatology

基　　金：江苏省卫生厅自然科学基金项目(YG201311);江苏大学临床科技发展基金项目(JLY20120103)

摘　　要：目的评价血清磷酯酰肌醇蛋白聚糖3(gpc3)和高尔基体蛋白73(gp73)的检测对肝细胞癌(HCC)的筛查作用。方法采集70例HCC癌及肝硬化(肝脏再生结节)患者基线时外周血。应用ELISA法检测患者血清gpc3和gp73,并与其血清AFP水平做对照。结果 HCC组gpc3、gp73测量值显著高于肝硬化组(P<0.01);gpc3诊断HCC的截断值>9.3μg/L,AUC=0.956,灵敏度为89.74%,特异度为96.77%,阳性预测值为97.2%,阴性预测值为88.2%,约登指数为0.8652,阳性似然比27.82,阴性似然比0.11,gp73诊断HCC的截断值>77.68μg/L,AUC=0.937,灵敏度为92.31%,特异度为83.87%,阳性预测值为87.8%,阴性预测值为89.7%,约登指数0.7618,阳性似然比5.72,阴性似然比0.092。结论血清gpc3与gp73水平可用于HCC的筛查。Objective To evaluate the effects of phosphatidylinositol proteoglycan 3 （GPC3 ）and Golgi protein 73 （GP73）levels on screen of early primary hepatocellular carcinoma （HCC）. Methods Seventy patients with HCC or liver cirrhosis （hepatic regenerative nodules）were enrolled. GPC3 and GP73 from peripheral serum were assessed by ELISA at baseline,and the relationships between GPC3/GP73 and liver histology/AFP were analyzed,respectively. Results GPC3 and GP73 levels in liver cancer group were significantly higher than those in liver cirrhosis group （P〈 0.001）;for GPC3, the cut-off value for HCC was 9.3 μg/l （AUC= 0.956）. Relevant indexes included sensitivity （89.74% ）,specificity （96.77% ）,positive predictive value （97.2% ）,negative predictive value （88.2% ）,the Youden＇s index （0.8652）,positive likelihood ratio （AUC= 0.956,＋LR,27.82）,and negative likelihood ratio （-LR,0.11）;for GP73,the cut-off value was 77.68 ng/ml （AUC= 0.937）with sensitivity of 92.31% ,specificity of 83.87% ,positive predictive value of 87.8% , negative predictive value of 89.7% ,the Youden index of 0.7618,positive likelihood ratio （AUC= 0.937,＋LR）of 5.72 and negative likelihood ratio （-LR）of 0.092. Conclusion GPC3 and GP73 levels can be used for screening early HCC.

关 键 词：磷酯酰肌醇蛋白聚糖3 高尔基体蛋白73 HCC 筛查 

分 类 号：R735.7[医药卫生—肿瘤]