联合检测AFP-L3%、GP73、GPC3在AFP低值原发性肝癌诊断中的价值  

Significance of combined test of serum AFP-L3%,GP73,GPC3 in diagnosing primary hepatic carcinoma with low level of AFP

作　　者：黄彩云[1] 李世龙[1] 周秀艳[1] 韩素桂[1] 

机构地区：[1]唐山市人民医院,河北唐山063000

出　　处：《现代肿瘤医学》2017年第21期3465-3467,共3页Journal of Modern Oncology

基　　金：河北省医学科学研究重点课题计划(编号:20110613)

摘　　要：目的:本研究探讨血清甲胎蛋白异质体3百分含量(AFP-L3%)、高尔基蛋白73(GP73)、磷脂酰肌醇蛋白聚糖3(GPC3)联合检测在AFP低值原发性肝癌(primary hepatic carcinoma,PHC)诊断中的临床价值。方法:选取58例AFP低值原发性肝细胞癌患者(PHC组)、62例良性肝病患者(良性肝病组)和55例体检健康者纳入本研究。采用微量离心柱法分离AFP-L3,电化学发光法检测AFP与AFP-L3,计算AFP-L3%。依据试剂盒推荐以AFP-L3%≥10%作为阳性界值。采用酶联免疫吸附法检测GP73、GPC3血清浓度,其诊断PHC的cut-off值由受试者工作特征曲线(recover operation characteristic,ROC)确定。结果:PHC组AFPL3%(16.58%±5.12%)明显高于良性肝病组(9.16%±3.86%)和健康对照组(5.11%±2.03%,P<0.001);PHC组GP73浓度(167.83±69.56)ng/ml明显高于良性肝病组(59.43±28.37)ng/ml和健康对照组(10.39±4.22)ng/ml,P<0.001;PHC组GPC3浓度(116.52±48.21)μg/L明显高于良性肝病组(28.43±11.25)μg/L和健康对照组(3.25±1.46)μg/L,P<0.001。以AFP-L3%≥10%作为阳性界值诊断PHC,诊断灵敏度为82.76%,特异度为82.05%,诊断正确率为82.28%;依据ROC曲线,GP73诊断PHC的cut-off值为81.86 ng/ml,诊断灵敏度为77.59%,特异度为82.91%,诊断正确率为81.14%;依据ROC曲线,GPC3诊断PHC的cut-off浓度为35.43μg/L,诊断灵敏度为70.69%,特异度为77.78%,诊断正确率为75.43%;联合检测AFP-L3%、GP73、GPC3水平诊断PHC的灵敏度为87.93%,特异度为84.62%,诊断正确率为85.71%。结论:肿瘤标志物AFP-L3%、GP73、GPC3可作为早期诊断和鉴别诊断PHC的良好指标,联合检测可显著提高诊断正确率。Objective：To explore the value of combined test serum AFP- L3%, GP73, GPC3 in the early diagno- sis of primary hepatocellular carcinoma （PHC） with low level of AFP. Methods： Select 58 eases of PHC with low lev- el of AFP,62 cases of begin liver diseases（BLD） and 55 cases of healthy controls for this study. AFP - L3 was sepa- rated by microspineolumn, the AFP and AFP - L3 were quantified by electrochemiluminescence immunoassays, per- centage of AFP - I_3 to total AFP was calculated. Computing the AFP - L3 % ,take AFP - L3% 〉10% as the critical level to dialogsis PHC. Use ELISA method to test the serum GP73 and GPC3 levels,use ROC curve to determine the cut- off levels to diagnosis PHC. Results：The percentage of AFP- L3% in the patients with PHC was （16.58% ± 5.12% ） significantly higher than those the patients with benign liver diseases （9. 16% ± 3.86% ） and that of healthy controls （5.11% ± 2.03 %, P 〈 0.001 ）. The level of GP73 in the patients with PHC was （ 167.83 ± 69.56） ng/ml significantly higher than those the patients with benign liver diseases （59.43 ± 28.37 ） ng/ml and that of healthy controls（ 10.39 ±4.22） ng/ml,P 〈0. 001. The average level of GPC3 in the patients with PHC was （ 116.52 ± 48.21 ） p,g/L significantly higher than those the patients with benign liver diseases （ 28.43 ＋ 11.25 ） μg/L and that of healthy controls （ 3.25 ± 1.46） μg/L, P 〈 O. 001 Take AFP - L3 % 〉 10% as the critical level, the sensitivity of AFP - L3% in PHC diagnosis was 82.76% and the specificity was 82.05% ,the accuracy was 82.28%. According to the ROC curve, take GP73 level 〉I 81.86 ng/ml as diagnostic criteria, the sensitivity of GP73 level in PHC diagno- sis was 77.59% and the specificity was 82.91%, the accuracy was 81. 14%. According to the ROC curver, take GPC3 level 〉135.43 μg/L as diagnostic criteria,the sensitivity of GPC3 level in PHC diagnosis was 70.69% and the specificity was 77.78% ,the accuracy was 75.43%. ParaUel use AFP -I3% and ser

关 键 词：原发性肝癌 甲胎蛋白异质体 高尔基体蛋白73 磷脂酰肌醇蛋白聚糖3 

分 类 号：R735.7[医药卫生—肿瘤]