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目的研究血清高尔基体糖蛋白-73(GP-73)对肝癌的诊断价值。方法时间分辨荧光免疫检测法(TR-FIA)检测79例肝癌、47例肝硬化、30例慢性肝炎及28名正常人血清中GP-73浓度,分析GP-73阳性率与肝癌大小及门脉转移的关系;同步比较GP-73浓度与γ-谷氨酰转移酶同工酶Ⅱ(GGT-Ⅱ)、甲胎蛋白(AFP)诊断肝癌的灵敏度及特异度,探讨三者对肝癌的联合诊断价值。结果肝癌组血清GP-73浓度明显高于肝硬化组、慢性肝炎组及正常对照组(均P<0.05)。根据ROC曲线,当界值为78.1 ng/L时,曲线下面积为0.814,GP-73对肝癌诊断敏感度及特异度分别为73.4%和79.0%。肝癌患者GP-73阳性率与肿瘤大小及有无门脉转移无相关性;血清GP-73、GGT-Ⅱ及AFP之间无相关性,联合检测三项指标可将诊断敏感度提高至96.3%。结论联合检测GP-73、GGT-Ⅱ和AFP可提高肝癌定性诊断水平。
Objective To investigate the diagnostic value of serum Golgi glycoprotein-73 (GP-73) in hepatocellular carcinoma (HCC). Methods The serum concentrations of GP-73 in 79 cases of HCC, 47 cases of cirrhosis, 30 cases of chronic hepatitis and 28 normal controls were detected by time-resolved fluorescence immunoassay (TR-FIA) The sensitivity and specificity of GP-73 and GGT-Ⅱ and AFP in the diagnosis of hepatocellular carcinoma (HCC) were synchronously compared, and the combination of GP-73 and hepatocellular carcinoma value. Results The serum GP-73 level in HCC group was significantly higher than that in cirrhosis group, chronic hepatitis group and normal control group (all P <0.05). According to the ROC curve, when the cutoff value was 78.1 ng / L, the area under the curve was 0.814, and the sensitivity and specificity of GP-73 in diagnosing HCC were 73.4% and 79.0%, respectively. The positive rate of GP-73 in hepatocellular carcinoma was not correlated with the tumor size and the presence or absence of portal vein metastasis. There was no correlation between GP-73, GGT-Ⅱ and AFP, and the combined detection of three indexes could increase the diagnostic sensitivity to 96.3% . Conclusion Combined detection of GP-73, GGT-Ⅱ and AFP can improve the qualitative diagnosis of liver cancer.