摘要
目的 探讨血清GP73是否可作为诊断肝细胞癌（HCC）的标志物,是否与HCC疾病进展相关.方法 采用ELISA法检测广东省人民医院2011年11月至2012年11月59例HCC患者、23例乙肝肝硬化患者及33名健康受试者外周血血清GP73含量,分析GP73在HCC诊断与疾病进展中的作用.结果 HCC患者GP73浓度在CP分级A、B级之间差异有统计学意义（P＜0.01）,与年龄、性别、BCLC分期、乙型肝炎、肿瘤直径、肿瘤转移、肿瘤个数之间差异无统计学意义;3组中HCC患者GP73浓度最高[127（147） μg/L,M（QR）],差异有统计学意义（P＜0.01）;根据ROC曲线确定GP73诊断HCC临界值为99 μg/L,灵敏性与特异性分别为64.4%、96.4%;GP73联合AFP检测组较单独检测提高了诊断灵敏性（P=0.025）,未能提高诊断特异性 （P=0.359）;血清GP73、AFP浓度在HCC患者mRECIST评价各阶段差异无统计学意义（P=0.959,P= 0.788）,基线GP73、AFP浓度与疾病进展时间之间无相关性（r=-0.119,P=0.608;r=0.142,P=0.540）.结论 血清GP73可作为HCC诊断标志物,联合AFP诊断效果较好;GP73和AFP在预测肝癌mRECIST评价中的作用尚需大规模临床试验证实.
Objective To explore the clinical application of serum GP73 in the diagnosis and progress of hepatocellular carcinoma （HCC）. Methods Enzyme-linked immunosorbent assay was employed to quantitatively detect serum GP73 in 59 HCC patients, 23 cases of hepatitis B virus （ HBV ）-related cirrhosis and 33 normal controls. The relationship between GP73 and diagnosis as well as progress of HCC was examined. Results Significant differences existed when serum GP73 was categorized by Child-Pugh class A and B （ P 〈 0. 01 ）. There was no correlation between GP73 levels and other parameters including age, gender, BCLC staging, HBV infection, tumor size, extrahepatic metastasis and tumor numbers. The serum GP73 with a mean level of [ 127（147） μg/L,M（QR） ] in HCC patients was significantly higher than that in normal controls or those with HBV-liver cirrhosis （P 〈 0.01 ）. Based on the ROC curve analysis, the cut-off value was 99 μg/L with 64. 4% sensitivity and 96. 4% specificity. The sensitivity of diagnosing HCC with GP73 plus AFP improved （ P = 0. 025 ） , but not in specificity. Serum GP73 and AFP did not change greatly in terms of response assessment in mRECIST from baseline to progressive disease （ P = 0. 959, P = 0. 788）. No correlation existed between baseline concentration of GP73 with AFP and time to progression （ r = 0. 119, P = 0.608 ; r = 0. 142, P = 0. 540 ）. Conclusion GP73 may become a potential serum marker for diagnosing HCC. And a combination of AFP yields better outcomes. The exact relationship between mRECIST and GP73 as well as AFP shall be proved by large-scale clinical trials.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第5期390-392,共3页
National Medical Journal of China
基金
广东省科技计划项目 （2011A030400009）
广东省自然科学基金（S2012010010569）
关键词
癌
肝细胞
高尔基体
甲胎蛋白类
Carcinoma, hepatocellular
Golgi apparatus
Alpha-Fetoproteins
