目的评价行肝动脉栓塞化疗术(TACE)的原发性肝癌患者手术前后血清高尔基体蛋白73(GP73)的动态变化及其临床意义;探讨肝癌患者血清GP73与肝功能等指标的相关性,从而找出判断肝癌患者TACE疗效及预后的新血清学标志物。方法应用酶联免疫吸附测定法(ELISA)检测50例行TACE治疗原发性肝癌患者手术前后的血清GP73水平,根据TNM分期、肝脏影像学、甲胎蛋白(AFP)、Child-Pugh分级、PS评分综合评估,将患者分为好转组(23例)和恶化组(27例),观察血清GP73的动态变化与临床转归的关系,并对患者术前血清GP73与肝功能各项指标进行相关性分析,对可能影响GP73水平的临床特征资料进行分析。结果好转组术后1周血清GP73水平较术前明显升高(F=19.47,P<0.0001),术后1～3个月血清GP73较术后1周下降(F=32.54,P<0.0001),且低于术前水平(P=0.0454)。恶化组术后1周及术后1～3个月血清GP73较术前均升高(F=36.71、37.2,P均<0.0001),术后1～3个月血清GP73与术后1周无明显变化(P=0.9111)。好转组术前及术后1周血清GP73分别与恶化组比较,均无显著差异(P=0.9693、0.6894);好转组术后1～3个月血清GP73水平较恶化组明显下降(P=0.0037)。两组患者术前血清GP73浓度与AFP水平均无相关性;而与白蛋白(ALB)水平呈负相关,与总胆红素(TBil)、谷氨酰转肽酶(GGT)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平呈正相关;血清GP73水平与是否有淋巴结肿大、是否存在腹水相关(P均<0.05)。结论血清GP73可以作为监测TACE治疗效果的有效指标,血清GP73可以反映肝癌患者肝功能状态。 Objective To evaluate the dynamic changes of serum GP73 before and after operation in patients with primary hepatocellular carcinoma treated with transcatheter arterial chemoembolization (TACE) and its clinical significance. To investigate the correlation between serum GP73 and liver function in patients with hepatocellular carcinoma Identify new serological markers to determine TACE efficacy and prognosis in patients with liver cancer. Methods Serum levels of GP73 were measured by enzyme linked immunosorbent assay (ELISA) in 50 patients with primary hepatocellular carcinoma before and after operation. According to TNM stage, liver imaging, AFP, Child-Pugh classification, PS The patients were divided into improvement group (23 cases) and worsening group (27 cases). The relationship between the dynamic changes of GP73 and clinical outcome was observed. Correlation between preoperative serum GP73 and liver function indexes Analysis of the clinical characteristics of the data that may affect the level of GP73. Results The level of GP73 in the improved group was significantly higher than that before the operation (F = 19.47, P <0.0001). The GP73 level of the improved group decreased from 1 week to 3 weeks after operation (F = 32.54, P <0.0001) , And lower than the preoperative level (P = 0.0454). The GP73 level of the malignant group was significantly higher than that of the preoperative one week and one to three months after operation (F = 36.71, 37.2, P <0.0001). The postoperative GP73 of the one to three months and the postoperative one week Significant changes (P = 0.9111). The serum levels of GP73 in the improved group were not significantly different from those in the worsened group (P = 0.9693,0.6894), respectively. The level of GP73 in the improved group was significantly lower than that in the worsened group (P = 0.0037 ). There was no correlation between preoperative serum GP73 concentration and the level of AFP in both groups, but negatively correlated with albumin (ALB) level. There was no significant correlation between GP73 concentration and total bilirubin (TBil), glutamyl transpeptidase (GGT) (P <0.05). There was a positive correlation between the level of AST, ALT and the level of serum GP73 in patients with lymphadenopathy (P <0.05). Conclusion Serum GP73 can be used as an effective indicator to monitor the therapeutic effect of TACE. Serum GP73 can reflect the liver function of patients with liver cancer.