磷脂酰肌醇蛋白聚糖-3在乙肝肝硬化患者中鉴别小肝癌的价值  

Value of serum glypican-3 in the differentiation of small hepatocellular carcinoma from hepatitis-B virus cirrhosis

作　　者：徐震[1] 朱善军[1] 马春芳[1] 郝天波 张肖 陆斐斐[1] 吴继华[1] XU Zhen;ZHU Shan-jun;MA Chun-fang;HAO Tian-bo;ZHANG Xiao;LU Fei-fei;WU Ji-hua(Department of Laboratory, Nantong University Affiliated Suzhou Wujiang District First People ＂s Hospital, Nantong, Jiangsu 215200, China)

机构地区：[1]南通大学附属苏州市吴江区第一人民医院检验科,江苏南通215200

出　　处：《现代预防医学》2018年第10期1900-1903,1915,共5页Modern Preventive Medicine

基　　金：院级科研立项合同(2017-22号)

摘　　要：目的探究磷脂酰肌醇蛋白聚糖-3(GPC-3)在乙肝肝硬化患者中鉴别小肝癌(SHCC)的价值。方法选取某院住院治疗的符合要求的乙肝肝硬化患者及乙肝肝硬化合并SHCC患者作为研究对象,分别定义为肝硬化组和SHCC组。收集2组患者的一般资料并利用单多因素分析筛选出导致肝硬化合并小肝癌的危险因素。利用ROC曲线分析各指标鉴别乙肝肝硬化合并SHCC的潜在诊断效能。结果本研究共纳入103例患者。其中肝硬化组共67例,SHCC组共36例。SHCC组患者的总胆红素、MRI检查、血清AFP、血清GPC-3等指标显著高于肝硬化组,差异均有统计学意义(P<0.05)。其中MRI检查、血清AFP和血清GPC-3是乙肝肝硬化合并SHCC的影响因素(P<0.05)。受试者的血清GPC-3和血清AFP呈正相关(r=0.222,P<0.05)。血清AFP和血清GPC-3鉴别乙肝肝硬化合并HCC的AUC为0.723和0.884,其敏感度为69.44%和66.67%,特异度为61.19%和100%;二者联合诊断鉴别乙肝肝硬化合并HCC的AUC最高(0.927)。结论 GPC-3在乙肝肝硬化患者中鉴别小肝癌时具有一定的价值,可作为诊断乙肝肝硬化合并小肝癌的指标之一。Objective To explore the value of serum glypican-3 in the differentiation of small hepatocellular carcinoma（SHCC）from hepatitis-B virus cirrhosis. Methods The patients with hepatitis-B cirrhosis and hepatitis-B cirrhosis with SHCC in our hospital were involved and divided into the cirrhosis group and the SHCC group. General data from both groups were recorded and single multi-factor analyses were used to screen risk factors for hepatitis-B cirrhosis with SHCC. ROC curve analysis was used to explore the potential diagnostic efficacy of hepatitis-B cirrhosis with SHCC. Results A total of 103 patients were enrolled in this study, including 67 patients in the cirrhosis group and 36 patients in the SHCC group. The total bilirubin, MRI examination, serum AFP and serum GPC-3 in the SHCC group were significantly higher than that in cirrhosis group,differences were statistically significant（P〈0.05）. Among them, MRI examination, serum AFP and serum GPC-3 were the factors for hepatitis-B cirrhosis combined with SHCC（P〈0.05）. Serum GPC-3 was positively correlated with serum AFP（r=0.222, P〈0.05）. The AUC serum AFP and serum GPC-3 in the differential diagnosis of hepatitis-B cirrhosis combined with SHCC were 0.723 and 0.884, and the sensitivity were 69.44% and 66.67%, the specificity was 61.19% and 100%. The AUC of combined diagnosis was highest（0.927）. Conclusion GPC-3 is valuable in the identification of hepatitis-B cirrhosis combined with SHCC. It can be used as one of the indicators in the diagnosis of hepatitis-B cirrhosis combined with SHCC.

关 键 词：磷脂酰肌醇蛋白聚糖-3 乙肝肝硬化 小肝癌 血清肿瘤标志物 

分 类 号：R181.2[医药卫生—流行病学]