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目的研究血清甘氨酰脯氨酸二肽氨基肽酶（ｇｌｙｃｙｌｐｒｏｌｉｎｅ ｄｉｐｅｐｔｉｄｙｌ ａｍｉｎｏｐｅｐｔｉｄａｓｅ，ＧＰＤＡ）同工酶对ＰＨＣ的诊断价值，提高早期 ＰＨＣ和 ＡＦＰ阴性ＰＨＣ诊断水平。方法采用阶段梯度垂直平板聚丙烯酰胺凝胶电泳法进行血清ＧＰＤＡ同工酶分离检测，同步测定比较ＰＨＣ患者血清ＧＰＤＡ同工酶与ＧＰＤＡ，Ｑ．活性（ＴＧＰＤ）、ＡＦＰ、肿瘤大小及ＡＬＴ的关系。结果血清ＧＰＤＡ按其泳动速度可分为快带（ＧＰＤＡ－Ｆ）与慢带（ＧＰＤＡ－Ｓ）两种同工酶。ＰＨＣ患者血清ＧＰＤＡ－Ｆ的阳性率为８５．３％，而肝外肿瘤、转移性肝癌、肝炎后肝硬化、慢性肝炎中阳性率均较低，正常对照组以及良性肝占位全部阴性。ＧＰＤＡ－Ｆ阳性率在ＴＧＰＤＡ活性增高组明显高于正常组（９４．４％对７５０％），ＧＰＤＡ－Ｆ与ＡＦＰ及肿瘤大小无关系。良性肝病ＡＬＴ升高组ＧＰＤＡ－Ｆ阳性率高于ＡＬＴ正常组，而ＰＨＣ患者ＧＰＤＡ－Ｆ与ＡＬＴ无关。ＰＨＣ患者ＧＰＤＡ－Ｆ呈持续阳性，良性肝病患者ＧＰＤＡ－Ｆ常为一过性阳性。结论ＧＰＤＡ－Ｆ为一新的ＰＨＣ血清标志物，有助于ＰＨＣ的定性诊断，尤其对早期ＰＨＣ及ＡＦＰ阴性ＰＨＣ的诊断具有重要价值。
Objective To investigate the diagnostic value of serum glycylproline dipeptidyl aminopeptidase (GPDA) isoenzymes in the diagnosis of PHC, and improve the early PHC and AFP negative PHC diagnostic levels. Methods Serum GPDA isoenzymes were separated and detected by phase gradient vertical polyacrylamide gel electrophoresis. Serum GPDA isoenzymes and GPDA were detected simultaneously in PHC patients. Activity (TGPD), AFP, tumor size and ALT relationship. [Results] Serum GPDA can be divided into two types of isoenzymes, GPDA-F and GPDA-S, according to their motility. The positive rate of serum GPDA-F in PHC patients was 85.3%. The positive rates of extrahepatic tumor, metastatic liver cancer, posthepatitic cirrhosis, and chronic hepatitis were all lower. The normal control group and benign liver occupying sites were all negative. The positive rate of GPDA-F was significantly higher in the TGPDA active group than in the normal group (94.4% vs. 750%). GPDA-F was not associated with AFP and tumor size. The positive rate of GPDA-F was higher in patients with benign liver disease with elevated ALT than in those with normal ALT, while GPDA-F was not associated with ALT in patients with PHC. GPDA-F was consistently positive in PHC patients, and GPDA-F was frequently transiently positive in patients with benign liver disease. Conclusion GPDA-F is a new serum marker of PHC, which is helpful for the qualitative diagnosis of PHC, especially for the diagnosis of early PHC and AFP-negative PHC.