高尔基体糖蛋白73在乙型肝炎相关性肝细胞癌患者血清及肝组织表达的研究

摘要

目的：探讨高尔基体糖蛋白（GP73）在乙型肝炎相关性肝细胞癌（HCC）患者血清及肝组织表达水平的变化及其意义。方法采用酶联免疫吸附试验（ELISA）检测慢性乙型肝炎患者20例、乙型肝炎肝硬化患者20例、乙型肝炎相关性HCC患者40例以及健康对照者10名血清GP73含量，绘制并计算ROC曲线下面积以及评价GP73对HCC的诊断价值；同时，对其中部分患者的肝组织进行免疫组织化学法，检测GP73的表达水平。结果乙型肝炎相关性HCC患者血清GP73含量为（204.03±90.69）ng/ml，均明显高于健康对照组、慢性乙型肝炎和肝硬化患者（P＜0.05）；慢性乙型肝炎、肝硬化患者血清 GP73含量也显著高于健康对照组（P＜0.05）。GP73诊断HCC的灵敏度和特异度分别为77.5%和84.0%；阳性预测值和阴性预测值分别为79.5%和82.4%；同时，GP73诊断HCC的ROC曲线下面积为0.81，其ROC曲线在AFP的ROC 曲线左上方；并且对AFP低值的HCC也有一定的诊断价值，GP73升高不受AFP影响。另一方面，肝组织中GP73呈棕黄色或深棕黄色染色，主要位于细胞质，HCC患者肝脏癌组织中GP73呈高表达，与肝硬化组和慢性乙型肝炎组比较，差异均有统计学意义（P＜0.05）。结论检测GP73有助于HCC的诊断和鉴别，可能提高目前对HHC的诊断率。%Objective To study the expression of Golgi glycoprotein(GP73) in serum and liver tissues from patients with hepatocellular carcinoma in a hepatitis B-endemic population. Methods Enzyme-linked immunosorbent assay (ELISA) was used to examine the expression of GP73 in serum from 40 patients with hepatocellular carcinoma(HCC) in a hepatitis B-endemic population, 20 patients with Chronic hepatitis B, 20 patients with hepatitis B liver cirrhosis, as well as 10 healthy blood donors. The receiver operating characteristic (ROC) curves of GP73 and AFP were both drawn and evaluated as a marker in diagnosis of HCC. Meanwhile, GP73 were detected by Immunohistochemistry assay in liver tissues from part of those patients. Results The level of GP73 in serum from patients with HCC was (204.03±90.69) ng/ml, which was significantly higher than those from patients with chronic hepatitis B, patients with liver cirrhosis or healthy controls, respectively. The sensitivity and specificity of GP73 in diagnosis of HCC were 77.5%and 84.0%;on the contrary, those of AFP in diagnosis of HCC were 52.5%and 90.0%respectively. The positive predictive value and negative predictive value were 79.5%and 82.4%. Meanwhile, the area under the receiver-operating characteristic(ROC) curve was 0.81 for GP73, which was on the upper left for AFP. What is more, GP73 can be used as biomarker in HCC diagnosis for patients which the level of AFP was low, as elevated GP73 was not affected by AFP. On the other hand, GP73 in liver tissue was stained for brown yellow or dark brown yellow, mainly in the cytoplasm. The degree of GP73 expression in liver tissues from patients with HCC was 81.31±1.98, which was markedly higher than that from patients with chronic hepatitis or patients with liver cirrhosis, respectively. Conclusion Detection of GP73 would be a useful marker for diagnosis and differentiation of HCC, which have a complementary feature for some HCC patients with AFP negative.