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目的:探讨高尔基体蛋白73(GP73)联合血清甲胎蛋白(AFP)诊断原发性肝癌的临床价值.方法:回顾分析230例原发性肝癌组患者、208例良性肝脏疾病患者、178例健康对照者的血清AFP、GP73检测结果,其中AFP测定采用电化学发光法,GP73测定采用酶联免疫吸附试验(ELISA).结果:血清AFP、GP73诊断原发性肝癌组的ROC曲线下面积(AUC)分别为0.787、0.903,血清GP73诊断原发性肝癌的AUC显著高于血清AFP(P<0.05).血清甲胎蛋白诊断原发性肝癌的cut-off值定为187.7μg/L,AFP检测的特异度为94.3%,敏感度为77.4%.血清GP73诊断原发性肝癌的cut-off值定为143.1μg/L,GP73检测的特异度为95.3%,敏感度为84.3%.PHC组GP73和AFP水平明显高于良性肝脏疾病组和健康对照组,差异有统计学意义(P<0.05).良性肝脏疾病组的血清GP73和AFP水平明显高于健康对照组(P<0.05).采用平行试验对血清AFP、GP73指标进行联合检测诊断原发性肝癌组的敏感度为94.7%(218/230),特异度为92.6%(358/386).联合检测诊断PHC组的敏感度明显高于单独检测血清AFP的敏感度(77.4%)和GP73的敏感度(84.3%)(P<0.05);而联合检测的特异度与单独检测血清AFP的特异度(95.3%)和GP73的特异度(94.3%)比较,差异无统计学意义(P>0.05).结论:单独检测血清AFP、GP73作为诊断原发性肝癌的敏感度较低,当两者联合时可以明显提高诊断灵敏度,从而有利于原发性肝癌组的诊断与鉴别诊断.
Objective: To investigate the clinical value of GP73 combined with serum alpha-fetoprotein (AFP) in the diagnosis of primary hepatocellular carcinoma.Methods: A retrospective analysis of 230 patients with primary liver cancer, 208 patients with benign liver disease, 178 healthy The serum AFP and GP73 were detected by ELISA, and the AFP was determined by electrochemiluminescence and GP73 by enzyme-linked immunosorbent assay (ELISA) .Results: The area under the ROC curve of serum AFP and GP73 in diagnosis of primary liver cancer group (AUC ) Were 0.787,0.903 respectively.The serum AFP was significantly higher than serum AFP in the diagnosis of primary hepatocellular carcinoma (P <0.05) .The cut-off value of serum alpha-fetoprotein in diagnosis of primary hepatocellular carcinoma was 187.7μg / L, The specificity was 94.3% and the sensitivity was 77.4% .The cut-off value of serum GP73 in diagnosis of primary liver cancer was 143.1μg / L, the specificity of GP73 was 95.3% and the sensitivity was 84.3% (P <0.05) .The levels of GP73 and AFP in benign liver disease group were significantly higher than those in healthy control group (P <0.05) .Patients in benign liver disease group were significantly higher than those in healthy control group (P <0.05), and the level of AFP in benign liver disease group was significantly higher than that in benign liver disease group and healthy control group Test of serum AFP, GP73 indicators for joint detection of primary liver cancer diagnosis The sensitivity was 94.7% (218/230) and the specificity was 92.6% (358/386). The sensitivity of combined detection of PHC group was significantly higher than that of serum AFP alone (77.4%) and GP73 (84.3% %) (P <0.05), but no significant difference was found between the specificity of combined detection and the specificity of serum AFP (95.3%) and GP73 (94.3%) separately.Conclusion: Serum AFP alone, GP73 as a diagnosis of primary liver cancer is less sensitive, when the combination of the two can significantly improve the diagnostic sensitivity, which is conducive to the diagnosis and differential diagnosis of primary liver cancer.