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目的通过联合检测磷脂酰肌醇蛋白聚糖-3(GPC3)、甲胎蛋白(AFP)在原发性肝癌患者血清及组织中的表达情况,探讨对原发性肝癌的诊断价值。方法分别采用ELISA和免疫组织化学法检测57例肝癌、74例肝炎后肝硬化患者和47例正常血清和肝组织GPC3、AFP表达水平,根据不同临床病理指标进行分组比较。结果 (1)肝癌患者、肝炎后肝硬化及正常对照者血清中GPC3水平分别为(212.6±137.5)、(60.9±27.8)、(39.5±18.7)ng/ml;肝癌患者血清GPC3浓度显著高于正常及肝炎后肝硬化患者(t=4.503,P<0.05;t=6.045,P<0.05);血清GPC3、AFP联合检测原发性肝癌的敏感性和特异性为84.2%和95.7%,均显著高于任一单项检测(t=4.132,P<0.05;t=6.514,P<0.05);(2)GPC3在肝癌组织表达高于癌旁和正常肝组织(t=3.724,P<0.05;t=15.799,P<0.05);GPC3与肿瘤大小、肿瘤数目、HBsAg及AFP水平无明显相关,而与病理分级和临床分期有关;(3)AFP阳性肝癌血清GPC3阳性率为91.4%,而在AFP阴性肝癌中GPC3阳性率为59.1%。结论 GPC3联合AFP检测有助于提高原发性肝癌的确诊率,检测GPC3有助于提高AFP阴性患者肝癌的确诊率。
Objective To investigate the expression of glypican-3 (GPC3) and alpha-fetoprotein (AFP) in the serum and tissues of patients with primary hepatocellular carcinoma (HCC). Methods The expression of GPC3 and AFP in 57 patients with hepatocellular carcinoma, 74 patients with posthepatitic cirrhosis and 47 normal serum and liver tissues were detected by ELISA and immunohistochemical method respectively, and compared according to different clinicopathological parameters. Results (1) The serum levels of GPC3 in patients with liver cancer, posthepatitic cirrhosis and normal controls were (212.6 ± 137.5) and (60.9 ± 27.8) and (39.5 ± 18.7) ng / ml, respectively. The sensitivity and specificity of combined detection of serum GPC3 and AFP in primary hepatocellular carcinoma were 84.2% and 95.7%, respectively, both in normal and post-hepatitis cirrhosis patients (t = 4.503, P <0.05; t = 6.045, (T = 4.132, P <0.05; t = 6.514, P <0.05); (2) The expression of GPC3 in HCC tissues was higher than that in paracancer and normal liver tissues (t = 3.724, P <0.05; = 15.799, P <0.05). There was no significant correlation between GPC3 and tumor size, tumor number, HBsAg and AFP levels, but related to pathological grade and clinical stage. (3) The positive rate of GPC3 in AFP positive hepatocellular carcinoma was 91.4% The negative rate of GPC3 in liver cancer was 59.1%. Conclusion GPC3 combined with AFP test can help to improve the diagnosis rate of primary liver cancer. Detecting GPC3 can improve the diagnosis rate of liver cancer in AFP negative patients.