AFP、AFU、GPC3及GP73联合检测对原发性肝癌的诊断意义

摘要

目的 探讨AFP、AFU、GP73和GPC3联合检测对原发性肝癌(primary hepatic cancer,PHC)的诊断价值.方法 收集荆州市中心医院2013年12月至2015年3月收治的PHC患者血清标本45例,肝硬化患者血清标本36例,乙型肝炎患者血清标本54例和健康体检者血清标本50例,分别检测各组研究对象血清AFP、AFU、GP73和GPC3水平,采用ROC曲线分析各标志物诊断PHC的价值.结果 PHC组患者血清AFP、AFU、GP73和GPC3表达水平均显著高于肝硬化组、乙型肝炎组和健康体检组(P<0.05).肝硬化组和乙型肝炎组患者血清AFP、AFU水平显著高于健康体检组(P<0.05).肝硬化组患者血清GP73水平显著高于乙型肝炎组患者(P<0.05),乙型肝炎组患者血清GP73水平显著高于健康对照组.联合AFP、AFU、GP73和GPC3检测的ROC曲线下面积为0.922,大于任何单一标志物检测.联合AFP、AFU、GP73和GPC3检测的敏感性、特异性和准确性分别为93.8%,81.5%和90.1%,其中敏感性和准确性明显高于任何单一标志物.结论 联合AFP、AFU、GP73和GPC3检测可以显著提高PHC的检出率和准确性,为临床早期诊断PHC提供可靠参考.%Objective To investigate the value of combined detection of AFP ,AFU,GP73 and GPC3 in the diagnosis of primary liver cancer .Methods Collected 45 cases of serum samples of PHC patients ,36 patients with liver cirrhosis ,54 patients with hepatitis B and 50 cases of healthy patients .Detected the levels of serum AFP ,AFU,GP73 and GPC3 in each group respec-tively,and used ROC curve to analyze the diagnostic value of PHC .Results The expression levels of AFP ,AFU,GP73 and GPC3 in the serum of patients with PHC were significantly higher than those in patients with cirrhosis ,hepatitis B group and healthy con-trol group (P<0.05).The serum AFP and AFU levels in liver cirrhosis group and hepatitis B patients were significantly higher than that in healthy control group (P<0.05).The serum level of GP73 in patients with liver cirrhosis was significantly higher than that of patients with hepatitis B(P<0.05),the level of serum GP73 in patients with hepatitis B was significantly higher than that in healthy control group .The area under the ROC curve of the combination of AFP ,AFU,GP73 and GPC3 was 0.922,larger than that of any single marker .The sensitivity,specificity and accuracy of the combined detection of AFP ,AFU,GP73 and GPC3 were 93.8%,81.5%and 90.1%,respectively,and the sensitivity and accuracy were significantly higher than those of any of the markers.Conclusion Combined detection of AFP ,AFU,GP73 and GPC3 can significantly improve the detection rate and accu-racy of PHC,and provide a reliable reference for the early diagnosis of PHC .