摘要
目的探讨高尔基体糖蛋白73(GP73)、α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)单项检测与联合检测对原发性肝癌的诊断价值。方法选择2011年5—9月初次就诊于我院的原发性肝癌患者80例为肝癌组,肝硬化患者65例为肝硬化组,慢性病毒性肝炎患者54例为肝炎组,同期健康体检正常者50例为对照组。采用酶联免疫定量法测定受检者血清GP73水平,免疫比浊法测定血清AFU水平,电化学发光法测定血清AFP水平。计算GP73、AFU、AFP单项检测与联合诊断原发性肝癌的受试者工作特征曲线下面积(AUC)、敏感度、特异度等。结果 4组受检者血清GP73、AFU、AFP水平比较,差异均有统计学意义(P<0.001)。GP73、AFU、AFP单项检测诊断原发性肝癌的AUC为0.804〔95%CI(0.746,0.862)〕、0.798〔95%CI(0.739,0.858)〕和0.797〔95%CI(0.731,0.862)〕,GP73、AFU诊断原发性肝癌的AUC与AFP比较,差异均无统计学意义(P>0.05)。GP73单项检测诊断原发性肝癌的敏感度(82.5%)、特异度(63.3%)与AFP(66.3%、88.7%)比较,差异均有统计学意义(χ2灵敏度=4.65,χ2特异度=28.91,P<0.05);AFU单项检测诊断原发性肝癌的敏感度(73.8%)与AFP比较,差异无统计学意义(χ2=0.89,P>0.05),特异度(77.5%)与AFP比较,差异有统计学意义(χ2=8.40,P<0.05)。联合检测中,GP73+AFU诊断原发性肝癌的敏感度为92.5%,GP73+AFU+AFP的敏感度为96.3%。结论 GP73对诊断原发性肝癌具有较好的敏感度,而AFP具有较好的特异度;GP73、AFU、AFP联合检测有利于提高原发性肝癌诊断率,减少漏诊。
Objective To explore the value of single and combined detection by Golgi Protein 73 （ GP73 ）, α - L - fucosidase （AFU） and α -fetoprotein （AFP） in the diagnosis of primary hepatic carcinoma （PHC）. Methods We included 80 patients with PHC who first visited our hospital between May and September 2011 into the PHC group, 65 patients with hepato- cirrhosis into the cirrhosis group, 54 patients with chronic viral hepatitis into the hepatitis group, and 50 healthy people into the control group. Enzyme - linked immunosorbent assay （ELISA） was used to determine the serum GP73 level of the subjects, ira- munoturbidimetry to determine AFU level, and electrochemiluminescence assay to determine serum AFP level. ROC curves of single and combined detection of PHC by GP73, AFU, and AFP were plotted to calculate the area under ROC curve （ AUC）, sensitivity, and specificity. Results Significant differences were observed among the four groups in serum GP73, AFU, and AFP levels （ P 〈 0.001 ）. The AUCs of single detection by GP73, AFUC, and AFP were 0. 804 [95 % CI （0. 746, 0. 862） ], 0. 798 [95%CI （0. 739, 0. 858） ], and 0. 797 [95% CI （0. 731, 0. 862） ], respectively, no significant difference found （P 〉 0. 05 ）. The single detection by GP73 had higher sensitivity （82. 5% ） and lower specificity （63.3%） than AFP（66. 3%, x2 =4. 65; 88.7%, x2 =28. 91 ; P 〈0. 05）. The sensitivity of single detection by AFU （73. 8% ） was not signifi- cantly different from that of AFP （66. 3%, x2 =0. 89, P 〉0.05）, while the specificity of AFU （77.5%） was lower than that of AFP （88. 7%, x2 = 8.40, P 〈 0. 05 ）. The sensitivity of combined detection by GP73 ＋ AFU and GP73 ＋ AFU ＋ AFP was 92. 5% and 96.3%, respectively. Conclusion GP73 has high sensitivity and AFP has high specificity in single detection of PHC. Combined detection by GP73, AFU, and AFP can greatly improve the detection rate of PHC.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第14期1581-1583,共3页
Chinese General Practice
基金
新疆医科大学第一附属医院青年科研专项基金(2011QN17)
吴阶平医学基金会临床科研专项资助基金(320.6799.1138)
乌鲁木齐市感染与肿瘤重点实验室(培育基地)课题(H111313001)
乌鲁木齐市科技局应用项目(Y111310002)
关键词
肝肿瘤
高尔基体
Α-L-岩藻糖苷酶
甲胎蛋白类
诊断
Liver neoplasms
Golgi apparatus
alpha - L - Fucosidase
alpha - Fetoproteins
Diagnosis
