Department of Clinical Biochemistry, Chinese PLA General Hospital, 28 Fuxing Rd, Beijing, China.
Int J Cancer. 2011 Oct 15;129(8):1923-31. doi: 10.1002/ijc.25838. Epub 2011 Mar 11.
We have investigated the changing rule of serum form of GP73 (sGP73) in different hepato-pathologic processes and identified the sGP73 role in inflammation, fibrosis and carcinogenesis since sGP73 has been regarded as a candidate tumor marker. Quantitative enzyme-linked immunosorbent assay detected sGP73 in 535 subjects with hepatocellular carcinoma (HCC), liver cirrhosis (LC), hepatitis, focal nodular hyperplasia (FNH), angioma, intra-hepatic cholangio-carcinoma (ICC) and metastatic cancer from adenocarcinomas (MC). Median sGP73 in LC was higher than in HCC and hepatitis (p = 0.001), and sGP73 in all three groups were higher than those in healthy individuals (p < 0.001); sGP73 in LC patients with Child-Pugh class A was lower than in class B and C (p = 0.001), no significant difference was found between early and advanced HCC groups (110.4 μg/L vs. 102.8 μg/L). AFP/GP73 had a sensitivity of 75.8% and specificity of 79.7% with an area under the receiver operating curve (AUROC) of 0.844 vs. 0.812 for AFP (p = 0.055) with a sensitivity of 95.2% and specificity of 47.1%; in detecting early HCC, AUROC of AFP/GP73 was 0. 804 vs. 0.766 for AFP (p = 0.086). sGP73 correlated with AST, AST/ALT, ALB, A/G and ALP in LC. The positive rate of sGP73 in angioma, FNH, ICC, and MC was 0, 50, 63.3, 53.3%, respectively; AFP/GP73 was 0.796 with the sensitivity of 81.4% and specificity of 70.0% when differentiating MC from AFP-negative HCC. Increased sGP73 is related to hepatic impairment and chronic fibrosis, and when combined with AFP could improve the differential diagnosis of hepatic diseases.
我们研究了血清 GP73 形式（sGP73）在不同肝病理过程中的变化规律，并确定了 sGP73 在炎症、纤维化和癌变中的作用，因为 sGP73 一直被认为是一种候选肿瘤标志物。采用定量酶联免疫吸附试验检测 535 例肝细胞癌（HCC）、肝硬化（LC）、肝炎、局灶性结节性增生（FNH）、血管瘤、肝内胆管癌（ICC）和腺癌转移癌（MC）患者的 sGP73。LC 组 sGP73 中位数高于 HCC 和肝炎组（p = 0.001），且三组 sGP73 均高于健康对照组（p < 0.001）；Child-Pugh 分级 A 的 LC 患者 sGP73 低于 B 和 C 级（p = 0.001），但早期与晚期 HCC 组之间无显著差异（110.4μg/L vs. 102.8μg/L）。AFP/GP73 的敏感性为 75.8%，特异性为 79.7%，ROC 曲线下面积（AUROC）为 0.844，优于 AFP 的 0.812（p = 0.055），其敏感性为 95.2%，特异性为 47.1%；在检测早期 HCC 时，AFP/GP73 的 AUROC 为 0.804，优于 AFP 的 0.766（p = 0.086）。sGP73 与 LC 中的 AST、AST/ALT、ALB、A/G 和 ALP 相关。血管瘤、FNH、ICC 和 MC 的 sGP73 阳性率分别为 0、50、63.3%和 53.3%；当 AFP 阴性 HCC 与 MC 相鉴别时，AFP/GP73 的敏感性为 81.4%，特异性为 70.0%，AUROC 为 0.796。sGP73 升高与肝损伤和慢性纤维化有关，与 AFP 联合使用可提高肝病的鉴别诊断能力。
