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目的评价分析原发性肝癌(PHC)患者血清高尔基体蛋白73(GP73)的变化规律,探讨GP73和甲胎蛋白(AFP)联合检测对原发性肝癌诊断和高危人群普查的意义。方法采用酶联免疫法检测70例原发性肝癌、40例肝硬化、40例肝炎患者的血清GP73、AFP水平,并与60名健康对照者进行比较。结果原发性肝癌组血清GP73的含量与肝硬化组、肝炎组及健康对照组比较,差异有统计学意义(U值分别为114.6、157.5、170.9,P<0.01),各组血清AFP的含量差异亦有统计学意义(U值分别为355.7、392.2、393.1,P均<0.01)。通过ROC曲线确定诊断原发性肝癌的临界值:GP73为123.2μg/L,AFP为10.6μg/L。这两个临界值下原发性肝癌组患者血清GP73、AFP单项检测的敏感度分别为64.3%和55.7%,特异度分别为92.1%和91.4%,二者联合检测的敏感度可达80%,特异度(90%)维持在较高水平。结论 GP73蛋白作为一种新的诊断原发性肝癌的肿瘤标志物,具有很好的敏感度和特异度。血清GP73和AFP联合检测可有效提高原发性肝癌诊断,为原发性肝癌的诊断和普查提供了一种新的敏感、特异、简便快捷的方法。
Objective To evaluate the changes of serum GP73 in patients with primary hepatic carcinoma (PHC), and to explore the significance of combined detection of GP73 and AFP in the diagnosis of primary liver cancer and screening of high risk population. Methods The serum levels of GP73 and AFP in 70 patients with primary hepatocellular carcinoma, 40 patients with cirrhosis and 40 patients with hepatitis were detected by enzyme-linked immunosorbent assay and compared with 60 healthy controls. Results The serum levels of GP73 in primary hepatocarcinoma group were significantly different from those in cirrhosis group, hepatitis group and healthy control group (U values were 114.6, 157.5, 170.9, P <0.01, respectively) The difference was also statistically significant (U values were 355.7,392.2,393.1, P <0.01). The critical value of diagnosis of primary liver cancer was determined by ROC curve: GP73 was 123.2μg / L and AFP was 10.6μg / L. The sensitivity of single detection of GP73 and AFP in patients with primary hepatocellular carcinoma was 64.3% and 55.7% respectively with specificity of 92.1% and 91.4%, respectively. The sensitivity of the combined detection of the two markers was 80% , Specificity (90%) maintained at a high level. Conclusion GP73 protein has a good sensitivity and specificity as a new tumor marker for diagnosis of primary liver cancer. Serum GP73 and AFP combined detection can effectively improve the diagnosis of primary liver cancer, which provides a new sensitive, specific, simple and quick method for the diagnosis and census of primary liver cancer.