GP73和AFP诊断HBSAg阳性原发性肝癌评价

目的 探讨血清高尔基体蛋白73(GP73)和甲胎蛋白(AFP)检测在HBSAg阳性原发性肝癌诊断中的价值.方法 对30例健康体检者,32例慢性乙型病毒性肝炎、36例乙肝肝硬化及57例原发性肝癌(HBSAg阳性)患者分别采用酶联免疫吸附试验和微粒子酶免疫分析技术检测血清GP73和AFP含量,并对检测结果进行统计学分析.结果 原发性肝癌(HBSAg阳性)患者血清GP73和AFP水平均显著高于其他疾病组及正常对照组(均P＜0.05).GP73和AFP诊断HCC的ROC曲线下面积(AUC)为0.862和0.729,95％置信区间为0.796～0.913和0.650～0.799.GP73的最佳诊断界限值为145 ng/ml,其预测的灵敏度为70.18％,特异度为93.33％.GP73的AUC大于AFP的AUC,两者AUC的差异有统计学意义(P＜0.01).结论 血清GP73对HBSAg阳性原发性肝癌的诊断价值可能优于AFP,可作为一项较好的诊断HCC的血清标志物.

Determination of Golgi protein 73 and Alpha-fetoprotein in the diagnosis of HBsAg hepatocellular carcinoma

Objective To explore the clinical diagnostic value of Golgi protein 73(GP73) and alpha-fetoprotein(AFP) for hepatocellular carcinoma(HCC) patients with HBsAg+.MethodsTThe serum GP73 and AFP were detected by enzyme-linked immunosorbent assay and microparticle chemiluminescent immunoassay in 32 patients infected with Hepatitis B virus hepatitis,36 cases of cirrhosis,57 cases of hepatocellular carcinoma)and 30 healthy controls.Then a statistical analysis was made on these results.ResultsTIn the patients with HCC(HBsAg+),the serum levels of GP73 and AFP were significantly higher than those in other patients and normal controls(all P<0.05),and the area under curve(AUC) generated by the ROC curves was 0.862(95%CI: 0.796～0.913) for GP73 and 0.729(95%CI: 0.650～0.799) for AFP.The best diagnostic threshold of GP73 was 145 ng/ml,and its sensitivity and specificity were 70.18% and 93.33%.The AUC of GP73 was bigger than that of AFP,and the difference was statistically significant(P<0.01).ConclusionsThe clinical diagnosis value of GP73 may be better than that of AFP,and GP73 could be a good serum marker in the diagnosis of hepatocellular carcinoma.