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目的探讨血清触珠蛋白(Hp)和高尔基体蛋白73(GP73)对AFP阴性原发性肝癌的临床诊断价值。方法收集70例肝硬化和76例原发性肝癌患者血清,对血清AFP、Hp和GP73浓度进行检测并分组比较,绘制受试者工作特征(ROC)曲线,分析血清Hp和GP73对AFP阴性原发性肝癌的诊断价值。结果肝癌患者的血清AFP、Hp和GP73浓度均显著高于肝硬化患者,差异有统计学意义(P<0.05);但AFP阴性和阳性肝癌患者血清Hp和GP73浓度差异无统计学意义(P>0.05)。血清AFP、Hp和GP73从肝硬化中鉴别诊断原发性肝癌的ROC曲线下面积(AUC)分别为0.601(0.504~0.690)、0.757(0.678~0.835)和0.670(0.582~0.757)(P<0.05),其中Hp的AUC显著高于AFP,差异有统计学意义(Z=3.029,P=0.002);血清Hp和GP73从AFP阴性肝硬化中鉴别诊断AFP阴性原发性肝癌的AUC分别为0.687(0.563~0.810)和0.736(0.621~0.851)(P<0.05)。结论血清Hp和GP73对原发性肝癌的诊断均有一定的价值,特别是血清GP73对AFP阴性肝癌的诊断有较好的临床应用价值。
Objective To investigate the clinical value of serum haptoglobin (Hp) and Golgi protein 73 (GP73) in the diagnosis of AFP negative primary liver cancer. Methods Seventy patients with cirrhosis and 76 primary hepatocellular carcinoma were enrolled in this study. Serum AFP, Hp and GP73 concentrations were detected and compared in groups. The receiver operating characteristic (ROC) curve was drawn. The effect of serum Hp and GP73 on AFP negative Diagnostic value of hepatocellular carcinoma. Results The serum levels of AFP, Hp and GP73 in patients with hepatocellular carcinoma were significantly higher than those in patients with cirrhosis (P <0.05), but there was no significant difference in serum Hp and GP73 levels between AFP negative and positive hepatocellular carcinoma patients (P> 0.05). The area under the ROC curve (AUC) of serum AFP, Hp and GP73 in the differential diagnosis of primary liver cancer from cirrhosis were 0.601 (0.504-0.690), 0.757 (0.678-0.835) and 0.670 (0.582-0.757) respectively (P <0.05 ), And the AUC of Hp was significantly higher than that of AFP (Z = 3.029, P = 0.002). The AUC of serum Hp and GP73 in differentiating AFP negative primary liver cancer from AFP negative cirrhosis was 0.687 0.563 ~ 0.810) and 0.736 (0.621 ~ 0.851) (P <0.05). Conclusion Serum Hp and GP73 have some value in the diagnosis of primary liver cancer, especially serum GP73 has a good clinical value in the diagnosis of AFP-negative liver cancer.