【摘要】 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(RT-PCR)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。更多还原

【Abstract】 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.更多还原