论文部分内容阅读
目的探讨高尔基体蛋白73(GP73)血清及其基因表达在原发性肝癌(primary hepatocellular carcinoma,PHC)中的诊断价值。方法采用酶联免疫吸附试验(ELISA)检测105例PHC、106例肝硬化患者和102例健康人的血清GP73和甲胎球蛋白(alpha-fetoprotein,AFP)水平。采用实时荧光定量(RT-PCR)法对各组外周血单个核细胞GP73 m RNA的拷贝数进行检测,采用Ct值比较法计算GP73 m RNA相对表达水平,并检测12份正常肝组织以及12份肝癌组织的GP73 m RNA相对表达水平。结果 PHC组GP73中位血清浓度明显高于肝硬化组,差异有显著统计学意义(P<0.05)。PHC组和肝硬化组患者的AFP中位血清浓度差异无统计学意义。GP73诊断肝癌的敏感度为72.7%,特异度为70.8%,AFP的敏感度为49.8%,特异度为95.9%。两者联合检测肝癌的敏感度为79.6%,特异度为80.3%。3组间全血GP73 m RNA含量无统计学差异,肝癌组织GP73 m RNA表达量(12.87)明显高于正常肝组织(1.08),差异有统计学意义(P<0.01)。结论 GP73诊断PHC具有较好的敏感度,GP73与AFP联合检测可进一步提高诊断早期肝癌的敏感度。肝组织标本GP73 m RNA可为诊断原发性肝癌的肿瘤标志,但存在创伤大、风险大等弊端。
Objective To investigate the diagnostic value of GP73 serum and its gene expression in primary hepatocellular carcinoma (PHC). Methods Serum GP73 and alpha-fetoprotein (AFP) levels in 105 patients with PHC, 106 patients with cirrhosis and 102 healthy controls were detected by enzyme linked immunosorbent assay (ELISA). The copy number of GP73 m RNA in each group of peripheral blood mononuclear cells was detected by real-time fluorescence quantitative PCR (RT-PCR), the relative expression level of GP73 m RNA was calculated by Ct value comparison method, and 12 normal liver tissues and 12 copies The relative expression level of GP73 m RNA in HCC tissues. Results The median serum concentration of GP73 in PHC group was significantly higher than that in cirrhosis group, the difference was statistically significant (P <0.05). There was no significant difference in AFP median serum concentrations between PHC group and cirrhosis group. The sensitivity and specificity of GP73 for hepatocellular carcinoma were 72.7% and 70.8% respectively. The sensitivity and specificity of AFP were 49.8% and 95.9% respectively. The sensitivity of the combined detection of liver cancer was 79.6% and the specificity was 80.3%. There was no significant difference in GP73 m RNA content among the three groups. The expression of GP73 mRNA in hepatocellular carcinoma tissue was significantly higher than that in normal liver tissue (1.08) (P <0.01). Conclusion GP73 has a good sensitivity in diagnosing PHC. Combined detection of GP73 and AFP can further improve the sensitivity of diagnosing early-stage liver cancer. GP73 m RNA can be a tumor marker for the diagnosis of primary liver cancer, but there are some disadvantages such as large trauma and high risk.