实用医学杂志 ›› 2021, Vol. 37 ›› Issue (8): 1068-1071.doi: 10.3969/j.issn.1006⁃5725.2021.08.021

• 医学检查与临床诊断 • 上一篇    下一篇

甲胎蛋白、甲胎蛋白异质体3比率、高尔基体蛋白73联合检测在原发性肝癌诊断中的价值

张晓坤1,司徒瑞儒   

  1.  1 广州市荔湾中心医院检验科(广州 510170);2 广州市海珠区中医医院检验科(广州 510220)
  • 出版日期:2021-04-25 发布日期:2021-04-25

Clinical value of combined detection of alpha⁃fetoprotein,alpha⁃fetoprotein alloplasm⁃3 ratio and Golgi so⁃ ma protein 73 in primary liver cancer

ZHANG Xiaokun,SITU Ruiru.   

  1. Department of Clinical Laboratory,Guangzhou Liwan Central Hospital,Guangzhou 510170,China
  • Online:2021-04-25 Published:2021-04-25

摘要:

目的 探讨甲胎蛋白(AFP)、甲胎蛋白异质体 3 比率(AFP⁃L3%)和高尔基体蛋白 73(GP73)联合检测在原发性肝癌中的临床诊断价值。方法 分别检测慢性肝炎组、肝硬化组和原发性肝癌组患者血清中 AFP、AFP⁃L3% GP73 水平和阳性率,并对数据进行分析比较。结果 慢性肝炎组、肝硬化组和原发性肝癌组三组 AFP 水平分别为(97.1 ± 88.2)、(208.2 ± 204.1)、(284.5 ± 275.2)ng/mL,与对照组比较均明显升高。原发性肝癌组 AFP 阳性率达 53.3%,与其他三组比较差异有统计学意义;原发性肝癌组 AFP⁃L3%水平和阳性率分别为(32.8 ± 21.3)% 75.0%,均较其他三组明显增高;慢性肝炎组、肝硬化组和原发性肝癌组三组 GP73 水平均比对照组明显增高,肝硬化组和原发性肝癌组 GP73 水平分别为(234.3 ± 91.8)ng/mL 和(224.3 ± 83.7)ng/mL,两组区别不大。GP73 的阳性率以肝硬化组最高为 71.9%。三项指标联合检测原发性肝癌的敏感度的特异性分别为 91.10% 97.2%,AUC 0.942,高于 单项检测指标。结论 甲胎蛋白(AFP)在作为原发性肝癌辅助诊断指标时更应同时监测 AFP⁃L3% GP73。GP73 在肝硬化和原发性肝癌诊断中的价值较高。如三者同时检测,可提高慢性肝炎、肝硬化和原发性肝癌的敏感率和准确率,对提高原发性肝癌的早期诊断价值,预测早期原发性肝癌方面有重要意义。

关键词:

Abstract:

Objective To investigate the clinical value of combined detection of alpha⁃fetoprotein(AFP), alpha⁃fetoprotein alloplasm⁃3 ratio(AFP⁃L3%)and Golgi somal glycoprotein 73(GP73)in primary liver cancer. Methods The levels and positive rates of AFP,AFP⁃L3% and GP73 in serum of patients with chronic hepatitis liver cirrhosis and primary liver cancer were detected,and the data were compared. Results AFP levels in chronic hepatitis group,cirrhosis group and primary liver cancer group were(97.1 ± 88.2)ng/mL,(208.2 ± 204.1)ng/mL 284.5 ± 275.2)ng/mL respectively,which were significantly higher than those in the control group. AFP positive rate in primary liver cancer group was 53.3%,which was significantly different from the other three groups. The level of AFP ⁃ L3% and the positive rate of AFP ⁃ L3% in primary liver cancer group were(32.8±21.3)% and 75.0%,respectively,the level of which were significantly higher than the other three groups. The levels of GP73 in chronic hepatitis,cirrhosis and primary liver cancer groups were significantly higher than those in the control group. The levels of GP73 in cirrhosis and primary liver cancer groups were 234.3 ± 91.8 ng/mL and 224.3 ± 83.7 ng/mL,respectively. There was no significant difference between the two groups. The positive rate of GP73 was the highest in the cirrhosis group(71.9%). The sensitivity and specificity of the combined detection of the three indexes were 91.10% and 97.2%,respectively,and the AUC was 0.942,which was higher than that of the single detection index. Conclusion AFP⁃L3% and GP73 should be monitored at the same time when AFP is used as an auxiliary diagnostic index of primary liver cancer. GP73 is of high value in the diagnosis of liver cirrhosis and primary liver cancer. If the three tests are carried out at the same time,the sensitivity rate and accuracy of chronic hepatitis cirrhosis and primary liver cancer can be improved. Thus,the value of early diagnosis of primary liver cancer can be improved,in the prediction of early primary liver cancer has important significance.

Key words:

Alpha fetoprotein, Alpha?fetoprotein heteroplasms, Golgi body transmembrane glycopro? tein 73, primary liver cancer, diagnostic value