血清GP73、GPC3、PIVKA-Ⅱ联合检测 对肝细胞癌的诊断价值  

Diagnostic value of combined detection of serum GP73,GPC3 and PIVKA-Ⅱin hepatocellular carcinoma

作　　者：郑燕苹 翁文翔 曾镇桦 梅序桥 吴阿阳 ZHENG Yanping;WENG Wenxiang;ZENG Zhenhua;MEI Xuqiao;WU Ayang(Department of Clinical Laboratory,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou,Fujian 363000,China;Department of Clinical Laboratory,the 909th Hospital/Dongnan Hospital of Xiamen University,Zhangzhou,Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院检验科,福建漳州363000 [2]第909医院/厦门大学附属东南医院检验科,福建漳州363000

出　　处：《检验医学与临床》2024年第24期3590-3594,共5页Laboratory Medicine and Clinic

基　　金：福建省自然科学基金项目(2020J011302)。

摘　　要：目的分析血清高尔基体糖蛋白73(GP73)、磷脂酰肌醇蛋白聚糖3(GPC3)、异常凝血酶原(PIVKA-Ⅱ)联合检测对肝细胞癌(HCC)的诊断价值。方法选取2021年7月至2023年8月福建医科大学附属漳州市医院收治的97例HCC患者作为研究组,另选取同期78例肝硬化患者作为良性对照组,78例体检健康者作为健康对照组。采用酶联免疫吸附试验检测血清GPC3水平;采用化学发光法检测血清GP73水平;采用化学发光微粒子免疫检测法检测血清PIVKA-Ⅱ水平。采用Pearson相关分析HCC患者血清GP73、GPC3、PIVKA-Ⅱ水平之间的相关性;采用多因素Logistic回归分析HCC发生的影响因素;采用受试者工作特征(ROC)曲线评估各项指标对HCC的诊断效能。结果3组有吸烟史、肝癌家族史患者比例比较,差异均有统计学意义(P<0.05)。研究组血清GP73、GPC3和PIVKA-Ⅱ水平均高于健康对照组和良性对照组,差异均有统计学意义(P<0.05)。良性对照组血清GP73、GPC3和PIVKA-Ⅱ水平均高于健康对照组,差异均有统计学意义(P<0.05)。HCC患者血清GP73水平与GPC3水平呈正相关(r=0.582,P<0.001),血清GP73水平与PIVKA-Ⅱ水平呈正相关(r=0.667,P<0.001),血清GPC3水平与PIVKA-Ⅱ水平呈正相关(r=0.639,P<0.001)。吸烟史、肝癌家族史、GP73、GPC3和PIVKA-Ⅱ均为HCC发生的独立影响因素(P<0.05)。血清GP73、GPC3和PIVKA-Ⅱ单独诊断HCC的曲线下面积(AUC)分别为0.826、0.834、0.849,3项指标联合检测诊断的AUC为0.964,明显大于各项指标单独检测的AUC(Z=4.809、5.050、4.469,P<0.05)。结论血清GP73、GPC3和PIVKA-Ⅱ水平与HCC的发生关系密切,3项指标联合检测能够较好地辅助诊断HCC。Objective To investigate the diagnostic value of combined detection of serum Golgi protein 73(GP73),glypican-3(GPC3)and abnormal prothrombin(PIVKA-Ⅱ)in hepatocellular carcinoma(HCC).Methods A total of 97 HCC patients admitted to Zhangzhou Hospital Affiliated to Fujian Medical University from July 2021 to August 2023 were selected as the study group,while 78 patients with cirrhosis during the same period were selected as the benign control group and 78 healthy individuals who underwent physical examinations were selected as the healthy control group.Enzyme-linked immunosorbent assay was used to detect the expression level of serum GPC3.Chemiluminescence method was used to detect the level of serum GP73,chemiluminescence partide immunmoassay mtehod was detected the level of PIVKA-Ⅱ.Pearson correlation analysis was used to investigate the correlations among serum GP73,GPC3 levels and PIVKA-Ⅱlevel in HCC patients.Multivariate Logistic regression analysis was used to identify the influencing factors of HCC occurrence.The diagnostic efficacy of various indicators for HCC was evaluated by receiver operating characteristic(ROC)curve.Results The proportions of patients with history of smoking and family history of liver cancer were compared among the three groups,the differences were statistically significant(P<0.05).The expression levels of serum GP73,GPC3 and PIVKA-Ⅱin the study group were higher than those in the healthy control group and the benign control group,the differences were statistically significant(P<0.05).The levels of serum GP73,GPC3 and PIVKA-Ⅱin the benign control group were higher than those in the healthy control group,the differences were statistically significant(P<0.05).The levels of serum GP73 and GPC3 correlated positively(r=0.582,P<0.001),and the expression levels of serum GP73 and PIVKA-Ⅱcorrelated positively(r=0.667,P<0.001),the levels of serum GPC3 and PIVKA-Ⅱcorrelated positively(r=0.639,P<0.001).Smoking history,family history of liver cancer,GP73,GPC3 and PIVKA-Ⅱwere the inde

关 键 词：肝细胞癌 高尔基体糖蛋白73 磷脂酰肌醇蛋白聚糖3 异常凝血酶原 诊断 

分 类 号：R446.9[医药卫生—诊断学] R735.7[医药卫生—临床医学]