AFP、APF-L3、GP73、AFP-mRNA联合检测在肝细胞癌诊断中的应用价值

摘要

Objective To investigate the application value of combined detection for alpha fetoprotein (AFP), alpha-fetoprotein-L3 ( AFP-L3 ) , Golgi protein 73 ( GP73 ) and AFP-mRNA in the diagnosis of hepatocellular carcinoma ( HCC). Methods Enzyme-linked immunosorbent assay ( ELISA) was used to detect the serum levels of GP73 in 73 cases of HCC,41 cases of liver cirrhosis,36 cases of chronic hepatitis B and 25 healthy subjects. AFP was detected by chemiluminescent immunoassay, and AFP-L3 was determined by adsorption centrifuging. AFP-mRNA was tested by fluorescent quantitative RT-PCR. Results There were significant differences in the levels of AFP, AFP-L3, GP73, AFP-mRNA between HCC group and cirrhosis group, normal control group ( P <0.01). The areas evaluated according to ROC curves were 0.691 ( AFP) ,0.859 ( APF-L3), 0.816 (GP73),0.762 (AFP-mRNA) respectively in HCC group,and the sensitivities were 54. 79% ,76. 71% , 80.82% ,53. 42%, respectively, and specificities were 79. 41% ,95. 10% ,82. 35% ,99. 02% , respectively. The areas under ROC curves for the four tumor-related markers were 0.958 by combined detection. The sensitivity of combined detection was significantly increased, which reached 95. 8% , and its specificity was 95. 0% in the diagnosis of HCC. Conclusion The combination detection for AFP, AFP-L3 ,GP73 and AFP-mRNA can obviously enhance the sensitivity and specificity in the diagnosis of HCC,which is superior to individual detection of AFP, AFP-L3.GP73 or AFP-mRNA.%目的 探讨甲胎蛋白(AFP)、甲胎蛋白异质体( AFP-L3)、高尔基体蛋白(GP73)及AFP-mR-NA联合检测在HCC诊断中的价值.方法 收集175例血清、其中肝细胞癌患者73例(HCC组)、肝硬化患者41例(肝硬化组)、慢乙肝患者36例(慢性肝炎组)、正常人25例(正常人组),采用酶联免疫法检测GP73,用化学发光法检测AFP,用亲和吸附离心法检测AFP-L3,采用荧光定量逆转录聚合酶链反应(RTPCR)法检测患者AFP-mRNA外周血的表达.结果 AFP、AFP-L3、GP73及AFP-mRNA在HCC组的含量与肝硬化组和正常组比较差异有统计学意义(P＜0.01),通过ROC曲线评价,AFP、AFP-L3、GP73及AFP-mRNA的曲线下面积分别为0.691、0.859、0.816、0.762,敏感度分别为54.79％、76.71％、80.82％、53.42％,特异度分别为79.41％、95.10％、82.35％、99.02％,四者联合检测的ROC曲线下面积为0.958,联合检测的敏感度明显提高达95.8％,特异度为95.0％.结论 AFP、AFP-L3、GP73及AFP-mRNA四者联合检测可显著提高肝细胞癌诊断的灵敏度和特异度.优于AFP、AFP-L3、GP73和AFP-mRNA的单项检测.