高尔基体蛋白 73（GOLPH2）是肝细胞癌有价值的血清标志物。

Golgi protein 73 (GOLPH2) is a valuable serum marker for hepatocellular carcinoma.

机构信息

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730 China.

出版信息

Gut. 2010 Dec;59(12):1687-93. doi: 10.1136/gut.2010.214916. Epub 2010 Sep 28.

DOI:10.1136/gut.2010.214916

PMID:20876776

Abstract

BACKGROUND AND AIMS

Golgi protein 73 (GP73) as a potential serum marker for hepatocellular carcinoma (HCC) has not been validated in large cohort studies. Furthermore, its significance in the assessment of tumour recurrence after HCC resection remains unknown. The aim of this study was to determine the value of serum GP73 in the diagnosis of HCC.

METHODS

Serum GP73 and alpha-fetoprotein (AFP) were compared in a total of 4217 human subjects in this multicentre study, including 1690 healthy adults, 337 hepatitis B virus (HBV) carriers, 512 patients with cirrhosis, 789 patients with HCC, 61 patients with other malignant liver lesions, 206 patients with benign liver lesions and 622 patients with 14 different kinds of non-liver cancers. The main outcome measures were the specificity and sensitivity of GP73 in patients at risk for the development of HCC.

RESULTS

Using 8.5 relative units as a cut-off value, the sensitivity and specificity of serum GP73 for HCC were 74.6% (95% CI 71.5% to 77.6%) and 97.4% (95% CI 96.8 to 98.3%), compared with 58.2% (95% CI 55.2% to 62.1%) and 85.3% (95% CI 83.4% to 88.1%) for AFP (p<0.001) using 35 ng/ml as a cut-off value. The GP73 level was significantly increased in patients with HCC compared with healthy controls (14.7 vs 1.2, p<0.001). Although GP73 levels in HBV carriers (2.9) and patients with cirrhosis (4.7) were somewhat elevated, they were much lower than that in patients with HCC (p<0.001). GP73 decreased following surgical resection of HCC lesions and increased with tumour recurrence. Fourteen types of non-liver cancers were analysed; all the benign and other malignant liver lesions had moderate elevations of GP73, albeit at a much lower level than in HCC.

CONCLUSIONS

GP73 is an accurate serum marker for the detection of HCC and its recurrence after surgery, with higher sensitivity and specificity than AFP. Clinical implementation of serum GP73 measurement as a standard test for HCC is recommended.

摘要

背景与目的

高尔基蛋白 73（GP73）作为一种潜在的肝细胞癌（HCC）血清标志物，尚未在大型队列研究中得到验证。此外，其在评估 HCC 切除术后肿瘤复发中的意义尚不清楚。本研究旨在确定血清 GP73 在 HCC 诊断中的价值。

方法

本研究采用多中心研究方法，共纳入 4217 名受试者，包括 1690 名健康成年人、337 名乙型肝炎病毒（HBV）携带者、512 名肝硬化患者、789 名 HCC 患者、61 名其他恶性肝脏病变患者、206 名良性肝脏病变患者和 622 名患有 14 种不同非肝脏癌症的患者。主要观察指标为 GP73 在 HCC 高危人群中的特异性和敏感性。

结果

以 8.5 相对单位为截断值，血清 GP73 对 HCC 的敏感性和特异性分别为 74.6%（95%CI 71.5%至 77.6%）和 97.4%（95%CI 96.8%至 98.3%），而以 35ng/ml 为截断值时，甲胎蛋白（AFP）的敏感性和特异性分别为 58.2%（95%CI 55.2%至 62.1%）和 85.3%（95%CI 83.4%至 88.1%）（P<0.001）。与健康对照组相比，HCC 患者的 GP73 水平明显升高（14.7 与 1.2，P<0.001）。尽管 HBV 携带者（2.9）和肝硬化患者（4.7）的 GP73 水平有所升高，但明显低于 HCC 患者（P<0.001）。HCC 病变切除术后，GP73 水平下降，肿瘤复发时升高。分析了 14 种非肝脏癌症；所有良性和其他恶性肝脏病变的 GP73 均有中度升高，尽管水平远低于 HCC。