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目的分析血清中高尔基糖蛋白73(GP73)在原发性肝癌诊断中的临床价值。方法选取经临床病理确诊的原发性肝癌患者67例(肝癌组)、肝硬化患者60例(肝硬化组)及体检正常人群60例(正常组),分别检测三组研究对象的血清GP73水平并进行比较分析,并分析不同临床病理特征的肝癌患者血清GP73水平的差异,同时以临床病理诊断结果作为金标准,评估GP73鉴别诊断肝癌与肝硬化患者的效能。结果肝癌组的血清GP73水平为(280.95±139.40)ng/ml,显著高于肝硬化组的(93.56±61.35)ng/ml和正常组的(24.97±12.63)ng/ml,且差异均有统计学意义(P<0.05);不同年龄、性别、肿瘤大小肝癌组患者血清GP73水平差异无统计学意义(P>0.05);发生远处转移、血管浸润、Ⅲ+Ⅳ期的肝癌患者的GP73显著高于未发生生远处转移、未血管浸润、Ⅰ+Ⅳ期的肝癌患者(P<0.05)。血清GP73诊断肝癌的灵敏度为65.67%,特异度为85.00%,漏诊率为34.33%,误诊率为15.00%,阳性预测值83.02%,阴性预测值68.92%,ROC曲线下面积AUC=0.780。结论 GP73在原发性肝癌的中高表达,在诊断肝癌中具有一定的临床价值。
Objective To analyze the clinical value of serum GP-73 in the diagnosis of primary liver cancer. Methods Sixty-seven patients with hepatocellular carcinoma (HCC), 60 patients with cirrhosis (cirrhosis) and 60 normal subjects (normal group) were enrolled in this study. Serum GP73 level The differences of GP73 levels in patients with hepatocellular carcinoma with different clinicopathological features were analyzed. The clinical and pathological findings were used as the gold standard to evaluate the efficacy of GP73 in the differential diagnosis of liver cancer and cirrhosis patients. Results The serum level of GP73 in hepatocellular carcinoma was (280.95 ± 139.40) ng / ml, which was significantly higher than that in cirrhosis (93.56 ± 61.35) ng / ml and normal group (24.97 ± 12.63) ng / ml (P <0.05). There was no significant difference in the serum levels of GP73 between different age, gender, tumor size and liver cancer group (P> 0.05). GP73 in patients with distant metastasis, vascular invasion and stage Ⅲ + Ⅳ was significantly higher Which was higher than that of patients without distant metastasis and without vascular invasion (stage Ⅰ + Ⅳ) (P <0.05). The sensitivity and specificity of GP73 for diagnosing HCC were 65.67%, 85.00%, 34.33% respectively. The misdiagnosis rate was 15.00%, the positive predictive value was 83.02% and the negative predictive value was 68.92%. The area under the ROC curve was 0.780. Conclusion GP73 is highly expressed in primary liver cancer and has certain clinical value in the diagnosis of liver cancer.