基于GALAD模型分析肝脏硬度测量值和高尔基体糖蛋白-73在丙型肝炎病毒相关肝细胞癌患者中的诊断价值  

Analysis of the expression and diagnostic value of Golgi protein 73 and liver stiffness measurement in hepatitis C virus-associated hepatocellular carcinoma patients based on GALAD model

作　　者：贾秋菊 刘换换 任楠 Jia Qiuju;Liu Huanhuan;Ren Nan(Department of Medical Laboratory,The First Affiliated Hospital of Xi'an Jiaotong University Yulin Hospital,Yulin 719000,Shaanxi,China;Department of Blood Transfusion,The First Hospital of Yulin,Yulin,719000,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院榆林医院医学检验科,陕西榆林719000 [2]榆林市第一医院输血科,陕西榆林719000

出　　处：《肿瘤综合治疗电子杂志》2024年第4期72-77,共6页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：陕西省重点研发计划(2020SF-034)。

摘　　要：目的基于GALAD模型分析高尔基体糖蛋白-73(Golgi protein 73,GP73)和肝脏硬度测量值(liver stiffness measurement,LSM)在丙型肝炎病毒(hepatitis C virus,HCV)相关肝细胞癌(hepatocellular carcinoma,HCC)患者中表达及诊断价值。方法选取2019年1月至2022年1月西安交通大学第一附属医院榆林医院收治的75例慢性HCV感染并确诊HCC患者(HCC组)和85例HCV感染非HCC患者(对照组)作为研究对象。采用全自动生化仪检测两组患者肝功能生化指标;采用全自动化学发光免疫分析仪分析两组患者甲胎蛋白(α-fetoprotein,AFP)、甲胎蛋白异构体L3(α-fetoprotein-L3,AFP-L3)、异常凝血酶原(des-γ-carboxy prothrombin,DCP)及GP73水平,并根据公式计算GALAD模型得分;采用肝纤维化无创扫描仪测量LSM;采用受试者工作特征曲线分析HCC诊断价值;采用Pearson相关方法进行相关性分析。结果HCC组患者肝功能指标、AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分均显著高于对照组(均P<0.05);HCC组患者不同肿瘤分期亚组AFP、DCP、AFP-L3、LSM、GP73水平及GALAD模型评分比较差异均有统计学意义(均P<0.05),且分期越晚指标水平和GALAD模型评分越高,各分期亚组间差异均有统计学意义(均P<0.05)。相关性分析显示,LSM、GP73水平与GALAD模型评分均呈线性正相关(r=0.622,P<0.001;r=0.532,P<0.001)。LSM、GP73及GALAD三项联合诊断HCC的曲线下面积为0.933,检测敏感度为94.56%,特异度为83.23%,均显著高于单独诊断(均P<0.05)。结论GALAD模型在HCV相关HCC诊断中显示了良好的效能,LSM、GP73作为HCC诊断标志物与GALAD模型评分呈正相关,且联合GALAD模型对HCC表现出更好的诊断效能。Objective Based on the GALAD model,analysed the expression and diagnostic value of Golgi protein 73(GP73)and liver stiffness measurement(LSM)in patients with hepatitis C virus(HCV)-associated hepatocellular carcinoma(HCC).Method 75 patients with chronic HCV infection and confirmed HCC admitted to The First Affiliated Hospital of Xi'an Jiaotong University Yulin Hospital from January 2019 to January 2022(HCC group)and 85 HCV-infected non-HCC patients(control group)were selected as study subjects.Fully automatic biochemistry was used to detect the biochemical indexes of liver function in the two groups of patients;alpha-fetoprotein(AFP),alpha-fetoprotein isoform L3(α-fetoprotein-L3,AFP-L3),abnormal prothrombin(des-γ-carboxy prothrombin,DCP)and GP73 levels were analysed in both groups using a fully automated chemiluminescent immunoassay analyser,and the GALAD model score was calculated according to the formula;LSM was measured using a non-invasive scanner for liver fibrosis;the diagnostic value of HCC was analysed using the subject's work characteristic curve;correlation analyses were performed using Pearson's correlation method.Result Liver function indexes,AFP,DCP,AFP-L3,LSM,GP73 levels and GALAD model scores of patients in the HCC group were significantly higher than those in control group(all P<0.05).The differences of AFP,DCP,AFP-L3,LSM,GP73 levels and GALAD model scores were statistically significant when comparing the different tumour stage subgroups of patients in the HCC group(all P<0.05),and the later the staging the higher the indicator levels and GALAD model scores,and the differences between the staging subgroups were statistically significant(all P<0.05).Correlation analysis showed a linear positive correlation between LSM,GP73 levels and GALAD model scores(r=0.622,P<0.001;r=0.532,P<0.001).The area under the curve for the combined diagnosis of HCC by LSM,GP73 and GALAD was 0.933,the sensitivity of the test was 94.56%,and the specificity was 83.23%,which were significantly higher than those of the diag

关 键 词：肝细胞癌 GALAD模型 高尔基体蛋白73 肝脏硬度测定 

分 类 号：R735.7[医药卫生—肿瘤] R512.63[医药卫生—临床医学]