Bao Yong-xing, Yang Ying, Zhao Hua-rong, Mao Rui, Xiao Lei, Zhang Yue-feng, Aisiker Tulahong, Wen Hao
Cancer Center of the First Affiliated Hospital at Xinjiang Medical University, Xinjiang,Urumqi 830054, China.
Zhonghua Zhong Liu Za Zhi. 2013 Jul;35(7):505-8.
To explore the clinical significance and diagnostic value of GP73 in early-stage primary hepatocelluar carcinoma (PHC).
GP73 levels in 50 healthy controls, 65 cases of liver cirrhosis and 40 early stage PHC were detected by ELISA. The areas under ROC, sensitivities and specificities were also compared. The relationship between GP73 and liver function parameters was analyzed.
The median of serum GP73 in early PHC was 291.3 µg/L, significantly higher than that in the cirrhosis group 211.8 µg/L and in the control group 58.3 µg/L (all P<0.01). The sensitivity of GP73 (72.5%) was significantly higher than that of AFP (50.0%), P<0.05. The specificity of GP73 (70.4%) was lower than that of AFP (95.7%), P<0.05. The sensitivity and specificity in combination for diagnosis were 77.5% and 79.1%, and the area under ROC curve in the combining form was 0.838 (95% CI:0.760-0.917). In the early PHC patients, the median of GP73 in the Child C group was 365.2 µg/L, significantly higher than that in the Child B group 310.6 µg/L and Child A group 266.4 µg/L, P = 0.002. In patients with liver cirrhosis, the median of GP73 in the Child B group was 307.3 µg/L, significantly higher than that in the Child A group 176.6 µg/L, P = 0.031. The level of serum GP73 was positively correlated with ALT, AST, negatively with ABL, A/G, and with no significant correlation with AFP, TBLB, DBLB, IBLB, and GGT.
GP73 has a superior sensitivity in detecting early-stage PHC in liver cirrhosis patients. The sensitivity can be further increased by combining with AFP. The changes of GP73 expression may be related with the decline of liver function.
探讨高尔基体蛋白73（GP73）在早期原发性肝细胞癌（PHC）中的临床意义及诊断价值。
采用酶联免疫吸附测定（ELISA）法检测50例健康对照者、65例肝硬化患者及40例早期PHC患者的GP73水平，并比较其受试者工作特征曲线（ROC）下面积、敏感度及特异度，分析GP73与肝功能参数的关系。
早期PHC患者血清GP73中位数为291.3μg/L，显著高于肝硬化组的211.8μg/L及对照组的58.3μg/L（均P<0.01）。GP73的敏感度（72.5%）显著高于甲胎蛋白（AFP）的敏感度（50.0%），P<0.05。GP73的特异度（70.4%）低于AFP的特异度（95.7%），P<0.05。联合诊断的敏感度和特异度分别为77.5%和79.1%，联合形式的ROC曲线下面积为0.838（95%可信区间：0.760 - 0.917）。在早期PHC患者中，Child C组的GP73中位数为365.2μg/L，显著高于Child B组的310.6μg/L及Child A组的266.4μg/L，P = 0.002。在肝硬化患者中，Child B组的GP73中位数为307.3μg/L，显著高于Child A组的176.6μg/L，P = 0.031。血清GP73水平与丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）呈正相关，与白蛋白（ALB）、白蛋白/球蛋白比值（A/G）呈负相关，与AFP、总胆红素（TBLB）、直接胆红素（DBLB）、间接胆红素（IBLB）及γ-谷氨酰转肽酶（GGT）无显著相关性。
GP73在检测肝硬化患者早期PHC方面具有较高的敏感度。与AFP联合可进一步提高敏感度。GP73表达的变化可能与肝功能下降有关。
