机构地区:[1]天津市和平区南营门街社区卫生服务中心,天津300041 [2]武警特色医学中心急诊科,天津300162 [3]天津医科大学第二医院肝胆胰外科,天津300211
出 处:《海南医学》2021年第19期2462-2465,共4页Hainan Medical Journal
基 金:天津市科技计划项目(编号:16ZXHLSY00120、15ZXLCSY00040);武警后勤学院基础研究项目(编号:WHJ201819)。
摘 要:目的探索高尔基体蛋白-73 (GP73)和骨桥蛋白(OPN)在肝癌肝硬化中的表达及对肝硬化分级辅助诊断的价值。方法选择2017年5月至2020年5月武警特色医学中心接收的72例肝癌肝硬化患者作为肝硬化组,选择同期40例健康体格检查者作为对照组,比较两组受检者的肝硬化相关指标和血清GP73、OPN水平,分析GP73、OPN与肝癌肝硬化相关指标、Child-Pugh分级以及肿瘤大小的关系,最后通过受试者工作特征曲线(ROC)分析GP73、OPN对肝癌肝硬化诊断的价值。结果与对照组比较,肝硬化组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原时间(PT)、总胆红素(TBIL)、甲胎蛋白(AFP)、OPN、GP73水平明显升高,血红蛋白(Hb)、白细胞(WBC)、血小板(PLT)、血浆白蛋白(ALB)水平明显下降,差异均具有统计学意义(P<0.05);GP73、OPN与AFP、TBIL、PT、Child-Pugh分级均呈正相关(P<0.05),与ALB均呈负相关(P<0.05);与肝癌直径<3 cm组比较,肝癌直径≥3 cm组患者的GP73和OPN表达水平明显升高,差异均具有统计学意义(P<0.05);AFP、OPN和GP73诊断肝癌肝硬化的灵敏度为73.6%、77.3%、79.2%,特异性为85.0%、87.5%、85.0%,而OPN、GP73与AFP联合诊断对肝癌肝硬化具有更高的灵敏度和特异性,分别为97.3%、71.5%。结论 GP73、OPN均与肝癌肝硬化指标及Child-Pugh分级相关,与AFP联合能够提高肝癌肝硬化检出率,可以作为肝癌肝硬化的辅助诊断指标。Objective To explore the expression of Golgi protein-73(GP73) and osteopontin(OPN) in liver cancer and liver cirrhosis and their value in the diagnosis of liver cirrhosis. Methods Seventy-two patients with liver cancer and liver cirrhosis accepted by the Special Medical Center of the Armed Police Force from May 2017 to May2020 were selected as the experimental group, and 40 healthy physical examination subjects during the same period were selected as the control group. The liver cirrhosis-related indicators, serum GP73, and OPN levels were compared between the two groups, and the relationship between GP73, OPN and liver cancer, liver cirrhosis-related indicators,Child-Pugh classification, as well as tumor size was analyzed. Rceiver operating characteristic(ROC) curve was used to analyze the value of GP73 and OPN in the diagnosis of liver cancer. Results Compared with the control group, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), prothrombin time(PT), total bilirubin(TBIL),alpha-fetoprotein(AFP), OPN, and GP73 significantly increased in the experimental group, and the levels of hemoglobin(Hb), white blood cells(WBC), platelets(PLT), and plasma albumin(ALB) were significantly decreased, with statistically significant differences(P<0.05). GP73, OPN were positively correlated with AFP, TBIL, PT, Child-Pugh grades(P<0.05), and negatively correlated with ALB(P<0.05). Compared with the liver cancer diameter<3 cm group, the expression levels of GP73 and OPN in the liver cancer diameter≥3 cm group were significantly higher(P<0.05). The sensitivity of AFP, OPN, and GP73 in diagnosing liver cancer and liver cirrhosis was 73.6%, 77.3%, 79.2%, and the specificity was 85.0%, 87.5%, 85.0%, while OPN, GP73 combined with AFP has higher sensitivity and specificity for liver cancer and liver cirrhosis(97.3% and 71.5%). Conclusion GP73 and OPN are both related to liver cancer and liver cirrhosis-related indicators and Child-Pugh classification. The combination with AFP can increase the detection r
关 键 词:肝癌肝硬化 高尔基体蛋白-73 骨桥蛋白 甲胎蛋白 CHILD-PUGH分级
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