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目的:研究血清白细胞介素6(interleukin 6,IL-6)和高尔基体蛋白73(Golgi protein-73,GP73)联合检测对原发性肝细胞癌(primary hepatocellular carcinoma,PHCC)的诊断价值。方法:采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA),检测50例经病理确诊的PHCC患者、107例肝硬化患者及50名正常对照者的血清IL-6和GP73水平。结果 :PHCC患者的血清IL-6水平(中位数147.57 pg/L)明显高于肝硬化患者(中位数30.75 pg/L)及正常对照者(中位数0.11 pg/L)(P<0.05);PHCC患者的血清GP73水平(中位数234.56 ng/m L)亦明显高于肝硬化患者(中位数128.04 ng/m L)及正常对照者(中位数43.87 ng/m L)(P均<0.05);PHCC患者血清中IL-6和GP73的阳性率(68.00%、60.00%)显著高于肝硬化患者(27.1%、37.4%)及正常对照者(6.0%、2.0%)(P均<0.05)。采用甲胎蛋白(alpha fetoprotein,AFP)联合IL-6或GP73诊断PHCC的灵敏度分别为76.0%和70.0%,均优于AFP单独检测(灵敏度46.0%);而3种血清标志物联合检测PHCC的灵敏度最高,为78.0%。IL-6及GP73水平与AFP水平间均无相关性,AFP阴性PHCC病例的IL-6阳性率为55.56%,GP73阳性率为44.45%。结论:IL-6和GP73可作为新的肿瘤标志物,可提高诊断PHCC的灵敏度,值得进一步扩大病例样本研究验证。
Objective: To investigate the diagnostic value of combined detection of serum interleukin 6 (IL-6) and Golgi protein-73 (GP73) in primary hepatocellular carcinoma (PHCC). Methods: Serum levels of IL-6 and GP73 in 50 PHCC patients diagnosed by pathology, 107 cirrhotic patients and 50 normal controls were detected by enzyme-linked immunosorbent assay (ELISA). Results: The serum level of IL-6 in PHCC patients (median 147.57 pg / L) was significantly higher than that in patients with cirrhosis (median 30.75 pg / L) and normal controls (median 0.11 pg / L) 0.05). The serum GP73 level of PHCC patients (median 234.56 ng / m L) was also significantly higher than that of cirrhosis patients (median 128.04 ng / m L) and normal controls (median 43.87 ng / m L) (P <0.05). The positive rates of serum IL-6 and GP73 in PHCC patients (68.00%, 60.00%) were significantly higher than those in cirrhosis patients (27.1%, 37.4%) and normal controls (6.0%, 2.0% (P <0.05). The sensitivity of using alpha fetoprotein (AFP) in combination with IL-6 or GP73 in the diagnosis of PHCC was 76.0% and 70.0%, respectively, which were better than AFP alone (sensitivity 46.0%); however, the combination of three serum markers for detecting PHCC The highest sensitivity, 78.0%. There was no correlation between IL-6 and GP73 levels and AFP levels. The positive rate of IL-6 in AFP-negative PHCC was 55.56% and the positive rate of GP73 was 44.45%. Conclusion: IL-6 and GP73 can be used as new tumor markers, which can improve the sensitivity of PHCC in diagnosing PHCC. It is worth to further expand the case study validation.