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目的探讨血清高尔基体糖蛋白73(GP73)联合甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、γ-谷氨酰转移酶(GGT)对早期筛查原发性肝癌的临床应用价值。方法收集肝癌实验组患者53例、其他恶性肿瘤对照组患者46例和健康人对照组20例血清,采用酶联免疫吸附试验(ELISA)定量检测法测定血清GP73浓度;化学发光免疫分析仪测定血清AFP、CEA、CA199水平;7600生化分析仪测定血清GGT水平。结果肝癌实验组患者血清GP73水平显著高于其他恶性肿瘤对照组和健康对照组(P<0.05)。ROC曲线分析显示,GP73诊断肝癌的灵敏度(86.8%)明显优于AFP(54.7%)(P<0.01),而特异性较AFP差(P<0.01)。在24例血清AFP呈低浓度的原发性肝癌患者中,血清GP73对肝癌的阳性检出率为75.0%,远高于AFP(P<0.01)。血清GP73联合AFP、CEA、CA199、GGT检测可显著提高肝癌诊断灵敏度,达98.1%。结论血清GP73和AFP、CEA、CA199、GGT联合检测可显著提高肝癌的检出率,对原发性肝癌的早期筛查和诊断具有临床意义。
Objective To investigate the effect of serum prokaryotic expression of GP73 combined with AFP, CEA, CA199 and GGT on early screening of primary Clinical value of HCC. Methods 53 cases of hepatocellular carcinoma in experimental group, 46 cases of other malignant tumor control group and 20 cases of healthy human control group were collected. Serum GP73 concentration was determined by enzyme-linked immunosorbent assay (ELISA). Chemiluminescence immunoassay AFP, CEA, CA199 levels; 7600 biochemical analyzer serum GGT levels. Results The level of serum GP73 in HCC experimental group was significantly higher than that in other malignant tumor control group and healthy control group (P <0.05). The ROC curve analysis showed that the sensitivity of GP73 in diagnosis of HCC was significantly better than that of AFP (54.7%) (P <0.01), but lower than AFP (P <0.01). The positive rate of GP73 in hepatocellular carcinoma was 75.0% in 24 cases of primary liver cancer with low serum AFP, which was much higher than that of AFP (P <0.01). Serum GP73 combined with AFP, CEA, CA199, GGT detection can significantly improve the diagnostic sensitivity of liver cancer, up to 98.1%. Conclusion Combined detection of serum GP73 and AFP, CEA, CA199 and GGT can significantly improve the detection rate of liver cancer, which has clinical significance for early screening and diagnosis of primary liver cancer.