5种血清标志物在肝癌诊断中的应用价值  

Application value of five serum markers in the diagnosis of hepatocellular carcinoma

作　　者：郝锐[1] 郑雪松[1] 张莲莲[1] 李卉[1] 刘楠楠 HAO Rui;ZHENG Xue-song;ZHANG Lian-lian;LI Hui;LIU Nan-nan(Department of Liver Diseases, Affiliated Hospital of Beihua University, Jilin 132001, China)

机构地区：[1]北华大学附属医院,吉林吉林132001

出　　处：《中国地方病防治》2018年第2期125-127,共3页Chinese Journal of Control of Endemic Diseases

基　　金：吉林省自然科学基金(20160101160JC)

摘　　要：目的探讨异常凝血酶原(DCP)、高尔基体蛋白73(GP73)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)和磷脂酰肌醇蛋白聚糖3(GPC-3)检测在原发性肝癌(HCC)诊断中的临床价值。方法回顾性分析65例原发性肝癌患者、85例肝硬化患者、70例慢性乙型病毒性肝炎患者的临床资料,同时选取67例健康对照者,分别检测DCP、GP73、AFP、AFPL3、GPC-3含量,计算AFP-L3占总AFP的比率。结果肝癌组DCP、GP73、AFP、AFP-L3及GPC-3血清浓度均明显高于其它非肝癌组(P<0.05)。单项检测中AFP的ROC曲线下面积最大(0.821),GP73灵敏度最高(78.5%),AFP-L3特异度最高(95.5%),DCP准确度最高(85.4%)。联合检测提高了诊断的灵敏度,5种标志物联合检测的灵敏度最高(98.5%)。结论 DCP、GP73、AFP、AFP-L3、GPC3可以作为诊断肝癌的标志物,联合检测可弥补单项检测的不足,值得临床推广。Objective To analyze the clinical value of desgamma carboxy prothrombin（ DCP）,golgi protein（ GP73）,alpha fetoprotein（ AFP）, AFP variants-L3（ AFP-L3） and glypican-3（ GPC-3） in the diagnosis of hepatocellular carcinoma（ HCC）.Methods From January 2016 to October 2017, 65 HCC patients,85 case of liver cirrhosis patients,70 cases of chronic viral hepatitis B（ CHB） patients and 67 healthy controls were selected from Affiliated Hospital of Beihua University.Detected the serum concentrations of DCP,GP73,AFP,AFP-L3,GPC-3, calculated the percentage content of AFP-L3. Results Serum levels of DCP,GP73,AFP,AFP-L3,GPC-3 in HCC patients were significantly higher than those of other non-HCC groups,and the difference was of ststistical significance（ P 〈 0. 05）. In single detection, the area under ROC Curve of AFP was maximum, GP73 has the highest sensitivity（ 78.5 %）,AFP-L3 has the highest specificity（ 95.5 %）,DCP has the highest accuracy（ 85.4 %）.Combined detection improves diagnostic sensitivity,the sensitivity of combined detection of 5 serum markers is the highest（ 98.5 %）. Conclusion DCP,GP73,AFP,AFP-L3,GPC-3 can be used as a serum marker for the diagnosis of HCC.Combined detection can make up for insufficient clinical applicaions of individual serum markers,and improve the sensitivity of diagnosis of HCC.

关 键 词：肝癌 血清标志物 诊断 

分 类 号：R735.7[医药卫生—肿瘤] R730.43[医药卫生—临床医学]