Zhu Jing, Jiang Feng, Ni Hong-Bing, Xiao Ming-Bing, Chen Bu-You, Ni Wen-Kai, Lu Cui-Hua, Ni Run-Zhou
Departments of Gastroenterology.
Exp Ther Med. 2013 Jan;5(1):89-94. doi: 10.3892/etm.2012.783. Epub 2012 Oct 31.
γ-glutamyl transferase isoenzyme II (GGT-II) is a sensitive biomarker of hepatocellular carcinoma (HCC). However, numerous disadvantages of the traditional manual method affected its application. The commercial kit provided a convenient and fast method for the determination of GGT-II levels. The purposes of the present study were to compare the reproducibility and sensitivity between the manual and commercial kit methods and to evaluate the diagnostic efficiency for HCC with the combined analysis of GGT-II, α-L-fucosidase (AFU) and α-fetoprotein (AFP). In patients with various liver diseases (HCC, liver cirrhosis and chronic hepatitis) and normal subjects, GGT-II was detected by manual and commercial polyacrylamide gel electrophoresis (PAGE). The levels of AFU and AFP were assayed by colorimetry and a chemiluminescence immunoassay, respectively. The commercial PAGE had equal diagnostic efficiency with traditional manual PAGE and no significant differences were observed in intra- and average-gel reproducibility and GGT-II sensitivities between the manual and commercial PAGE (P>0.05). The incidence of GGT-II detected by commercial PAGE in HCC patients was 84.1% and <8% in benign liver disease. The levels of AFU and AFP in the benign liver diseases and normal subjects were lower than those in HCC. According to the cut-off value obtained by receiver operating characteristic curves, a total of 56.6 and 59.3% of HCC patients (64 out of 113 and 67 out of 113) had AFU >636.5 μmol/l h and AFP >44.0 μg/l, respectively. There were no significant correlations between GGT-II and AFU or AFP. Combined detection of GGT-II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial PAGE provides a simple and reproducible method for GGT-II detection. Combined determination of GGT-II with AFU or AFP exhibited superior sensitivity and specificity for the diagnosis of HCC.
γ-谷氨酰转移酶同工酶II（GGT-II）是肝细胞癌（HCC）的一种敏感生物标志物。然而，传统手工方法存在诸多缺点，影响了其应用。商业试剂盒为测定GGT-II水平提供了一种便捷快速的方法。本研究的目的是比较手工方法和商业试剂盒方法之间的重现性和敏感性，并通过联合分析GGT-II、α-L-岩藻糖苷酶（AFU）和甲胎蛋白（AFP）来评估对HCC的诊断效率。在患有各种肝脏疾病（HCC、肝硬化和慢性肝炎）的患者以及正常受试者中，采用手工和商业聚丙烯酰胺凝胶电泳（PAGE）检测GGT-II。分别采用比色法和化学发光免疫分析法检测AFU和AFP水平。商业PAGE与传统手工PAGE具有相同的诊断效率，在手工和商业PAGE之间，凝胶内和凝胶间的重现性以及GGT-II敏感性均未观察到显著差异（P>0.05）。商业PAGE检测HCC患者中GGT-II的发生率为84.1%，在良性肝病中<8%。良性肝病和正常受试者中AFU和AFP的水平低于HCC患者。根据通过受试者工作特征曲线获得的临界值，分别有56.6%和59.3%的HCC患者（113例中的64例和113例中的67例）AFU>636.5μmol/l·h以及AFP>44.0μg/l。GGT-II与AFU或AFP之间无显著相关性。GGT-II与AFU或AFP联合检测可将诊断敏感性分别提高到92.9%和93.8%。这些结果表明，商业PAGE为GGT-II检测提供了一种简单且可重复的方法。GGT-II与AFU或AFP联合测定对HCC的诊断具有更高的敏感性和特异性。
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