原发性肝细胞癌与胆管细胞癌中高尔基体蛋白73及甲胎蛋白表达的临床意义  

Clinical Significance of Golgi Protein 73 and Alpha Fetoprotein in Primary Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

作　　者：孙景武[1] 刘志春[1] 张雷 张龙[1] 张帆[1] SUN Jingwu;LIU Zhichun;ZHANG Lei(Central Hospital of China National Petroleum Corporation,Langfang,065000)

机构地区：[1]中国石油天然气集团公司中心医院,065000

出　　处：《实用癌症杂志》2019年第5期737-742,共6页The Practical Journal of Cancer

基　　金：廊坊市科技支撑计划项目(编号:2015013009C)

摘　　要：目的探讨原发性肝细胞癌(hepatocellular carcinoma,HCC)与胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)中高尔基体蛋白73(golgi protein 73,GP73)及甲胎蛋白(alpha-fetoprotein,AFP)的表达意义。方法收集HCC患者40例、ICC患者35例、乙型肝炎与肝硬化患者共50例,同期收取健康体检者44例。采用单因素方差分析和两独立样本t检验分别比较多组间和2组间血清GP73和AFP水平。相关性分析采用Spearman检验。受试者工作特征曲线(receiver operator characteristic curve,ROC)分析计算GP73和AFP鉴别HCC和ICC的价值。结果 4组间AFP和GP73水平差异具有统计学意义(AFP:F=4. 017,P=0. 003; GP73:F=5. 331,P <0. 001)。与HCC组相比,ICC组、乙型肝炎与肝硬化组和健康对照血清AFP和GP73水平均显著降低,且差异具有统计学意义(P <0. 001)。而ICC组、乙型肝炎与肝硬化组和健康对照血清AFP和GP73水平差异无统计学意义(P> 0. 05)。HCC患者血清GP73与淋巴结转移(有vs无:t=3. 817,P=0. 005; R2=0. 289,P <0. 001)和TNM分级(Ⅰ～ⅡvsⅢ～Ⅳ:t=-3. 285,P=0. 013; R2=0. 256,P <0. 001)呈线性关联。ROC曲线分析显示,在区分HCC与非肿瘤组的灵敏度/特异度血清GP73和AFP分别为:78. 3%/91. 2%和64. 7%/76. 1%,联合血清GP73和AFP时的灵敏度为81. 7%,特异度为89. 8%;在区分HCC与ICC患者的灵敏度/特异度血清GP73和AFP分别为:80. 1%/87. 6%和73. 2%/62. 4%,当联合血清GP73和AFP时的灵敏度为78. 5%,特异度为90. 4%。结论 GP73在HCC鉴别诊断上优于AFP的诊断效能,联合GP73与AFP对HCC与ICC及HCC与非肿瘤的鉴别诊断具有更高的价值,有望为找寻HCC的诊疗提供新的途径与思路。Objective To explore the clinical value of golgi protein 73( GP73) and alpha fetoprotein( AFP) in primary hepatocellular carcinoma( HCC) and intrahepatic cholangiocarcinoma( ICC). Methods 40 cases of HCC,35 cases of ICC,50 cases of hepatitis B and cirrhosis were included. Moreover,44 cases of healthy controls were collected at the same time. The levels of serum GP73 and AFP between multiple groups and two groups were compared by one-way ANOVA and Student’s t-test,respectively. Spearman test was used for the correlation analysis. The receiver operating characteristic( ROC) curve analysis was performed to estimate the diagnostic values of GP73 and AFP in HCC and ICC patients. Results The differences of AFP and GP73 levels between the four groups were statistically significant( AFP: F = 4. 017,P = 0. 003,GP73: F = 5. 331,P < 0. 001). Compared with the HCC group,the levels of serum AFP and GP73 in the ICC group,hepatitis B and liver cirrhosis group and the healthy control group were significantly decreased,and the differences were statistically significant( P < 0. 001). There was no significant difference in serum AFP and GP73 levels between ICC group,hepatitis B and cirrhosis group and healthy controls( P> 0. 05). The serum GP73 of HCC patients was linearly associated with lymph node metastasis( t = 3. 817,P = 0. 005;R2=0. 289,P < 0. 001) and TNM classification( t =-3. 285,P = 0. 013;R2= 0. 256,P < 0. 001). ROC curve analysis showed that GP73 and AFP possessed a remarkable ability for discrimination between HCC group and non-tumor group,and the sensitivity and specificity were 78. 3%/91. 2% and 64. 7%/76. 1% respectively. Combination of GP73 and AFP possessed a remarkable ability for discrimination between HCC group and non-tumor group,and the sensitivity and specificity were 81. 7% and 89. 8%,respectively. Moreover,GP73 and AFP possessed a remarkable ability for discrimination between HCC group and ICC group,and the sensitivity and specificity were 80. 1%/87. 6% and 73. 2%/62. 4% respectively. Combination of GP73

关 键 词：肝细胞癌 胆管细胞癌 高尔基体蛋白73 甲胎蛋白 临床价值 

分 类 号：R735.7[医药卫生—肿瘤]