免疫组化检测磷脂酰肌醇蛋白多糖-3与细胞角蛋白-19在肝细胞癌诊断中的应用价值分析  

Analysis of the application value of immunohistochemical detection of GPC-3 and CK-19 in the diagnosis of hepatocellular carcinoma

作　　者：杨丽英 朱杰 Yang Liying;Zhu Jie(Southern Central Hospital of Yunnan Province(Honghe First People's Hospital),Honghe,Yunnan661199)

机构地区：[1]云南省滇南中心医院(红河州第一人民医院),云南红河661199

出　　处：《基层医学论坛》2023年第34期113-115,140,共4页The Medical Forum

摘　　要：目的探讨免疫组化检测磷脂酰肌醇蛋白多糖-3(human glypican-3,GPC-3)、细胞角蛋白-19(cytokeratin-19,CK-19)在肝细胞癌诊断中的应用价值。方法选取2010年1月—2022年6月云南省滇南中心医院收治的103例疑似肝细胞癌患者为研究对象,所有患者均进行免疫组化检测GPC-3与CK-19,并以病理检查结果为金标准,计算免疫组化检测GPC-3、CK-19对肝细胞癌的诊断效能。比较不同病灶直径、分化程度的肿瘤组织中GPC-3、CK-19的表达情况。结果GPC-3检测诊断肝细胞癌的灵敏度、特异度、准确度分别为86.1%(62/72)、80.6%(25/31)、84.5%(87/103),CK-19检测诊断肝细胞癌的灵敏度、特异度、准确度分别为81.9%(59/72)、74.2%(23/31)、79.6%(82/103),二者比较差异均无统计学意义(P>0.05)。Kappa检验分析结果显示,GPC-3、CK-19检测诊断肝细胞癌与病理检查结果的一致性中等(Kappa值=0.644、0.537,P<0.05)。病灶直径≥5 cm肿瘤组织中的GPC-3、CK-19的阳性表达率显著高于病灶直径<5 cm的肿瘤组织,差异有统计学意义(Z=-2.808、-2.761,P<0.05)。中低分化肿瘤组织中GPC-3、CK-19的阳性表达率显著高于高分化肿瘤组织,差异有统计学意义(Z=-4.883、-2.353,P<0.05)。结论免疫组化检测GPC-3、CK-19对肝细胞癌具有一定的诊断价值,二者在病灶组织中的表达可能与病灶大小、分化程度有关。Objective To explore the application value of immunohistochemical detection of GPC-3 and CK-19 in the diagnosis of hepatocellular carcinoma.Methods 103 patients with suspected hepatocellular carcinoma admitted to Southern Central Hospital of Yunnan Province from January 2010 to June 2022 were selected as study subjects.All patients were detected by immunohistochemistry for GPC-3 and CK-19,and the diagnostic efficacy of immunohistochemistry for hepatocellular carcinoma was calculated based on the pathological results as the gold standard.The expression of GPC-3 and CK-19 in tumor tissues with different lesion diameters and differentiation degrees were compared.Results The sensitivity,specificity and accuracy of GPC-3 in the diagnosis of hepatocellular carcinoma were 86.1%(62/72),80.6%(25/31)and 84.5%(87/103),the sensitivity,specificity and accuracy of CK-19 in the diagnosis of hepatocellular carcinoma were 81.9%(59/72),74.2%(23/31)and 79.6%(82/103),there was no significant difference between the two indexes(P>0.05).Kappa test analysis results showed that GPC-3 and CK-19 were moderately consistent with pathological Results in the diagnosis of hepatocellular carcinoma(Kappa values=0.644,0.537,P<0.05).The positive expression rate of GPC-3 and CK-19 in tumor tissues with lesion diameter≥5cm was significantly higher than that in tumor tissues with lesion diameter<5cm(Z=-2.808,-2.761,P<0.05).The positive expression rates of GPC-3 and CK-19 in medium and low differentiated tumor tissues were significantly higher than those in high differentiated tumor tissues(P<0.05).Conclusion Immunohistochemical detection of GPC-3 and CK-19 has certain diagnostic value for hepatocellular carcinoma.The expression of GPC-3 and CK-19 may be related to the size and differentiation of the lesion.

关 键 词：免疫组化 GPC-3 CK-19 肝细胞癌 

分 类 号：R446.6[医药卫生—诊断学]