Wang Yuan-Yuan, Zhou Chen-Jie, Li Jing, Zhou Ling, Li Ming-Song, Xiao Bing
1Department of Oncology, 2Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Aug 20;37(8):1060-1065. doi: 10.3969/j.issn.1673-4254.2017.08.10.
To explore the clinical value of detecting serum glypican-3 in the diagnosis and therapeutic effect evaluation of primary hepatocellular carcinoma (PHC).
Using sandwich ELISA, we detected serum glypican-3 levels in 60 patients with PHC, 60 with metastatic liver cancer, 50 with liver cirrhosis, 50 with chronic viral hepatitis, 20 with hepatic cyst, 20 with fatty liver, 20 with hepatic hemangioma and 20 with drug-induced hepatitis as well as in 40 healthy subjects (control). We also analyzed the changes in serum levels of glypican-3 and alpha fetoprotein (AFP) in PHC patients after treatment.
PHC patients had significantly higher serum levels of glypican-3 than patients with other liver diseases and the control subjects (P<0.05). The levels of serum glypican-3 were significantly higher in patients with metastatic liver cancer, liver cirrhosis and viral hepatitis than in those with other benign liver diseases and the control subjects (P<0.05). Glypican-3 level was not associated with AFP level or liver function in PHC patients, in whom the positivity rates for glypican-3 and AFP were 65% and 56.7%, respectively. The detection rate of PHC increased to 85% by a combined detection of AFP and glypican-3. In the 23 PHC patients who responded positively to treatments, serum glypican-3 level showed a steady decline compared with that in 15 patients before treatment, while serum AFP level showed a similar decrease only in 10 patients.
Combined detection of glypican-3 and AFP is expected to improve the early diagnosis rate of PHC. The different thresholds of serum glypican-3 may play a role in the differential diagnosis of PHC and other various liver diseases. Glypican-3 may serve as a better marker than AFP with a high specificity and sensitivity for evaluating the therapeutic effect in PHC patients.
探讨检测血清磷脂酰肌醇蛋白聚糖-3（Glypican-3）在原发性肝细胞癌（PHC）诊断及疗效评估中的临床价值。
采用夹心酶联免疫吸附测定法（ELISA），检测60例PHC患者、60例转移性肝癌患者、50例肝硬化患者、50例慢性病毒性肝炎患者、20例肝囊肿患者、20例脂肪肝患者、20例肝血管瘤患者、20例药物性肝炎患者以及40例健康对照者血清中Glypican-3水平。同时分析PHC患者治疗后血清Glypican-3和甲胎蛋白（AFP）水平的变化。
PHC患者血清Glypican-3水平显著高于其他肝病患者及健康对照者（P<0.05）。转移性肝癌、肝硬化及病毒性肝炎患者血清Glypican-3水平显著高于其他良性肝病患者及健康对照者（P<0.05）。PHC患者中，Glypican-3水平与AFP水平及肝功能无关，Glypican-3和AFP的阳性率分别为65%和56.7%。联合检测AFP和Glypican-3使PHC的检出率提高至85%。在23例治疗反应阳性的PHC患者中，血清Glypican-3水平与治疗前15例患者相比呈稳步下降，而血清AFP水平仅在10例患者中呈类似下降。
联合检测Glypican-3和AFP有望提高PHC的早期诊断率。血清Glypican-3的不同阈值可能在PHC与其他各种肝病的鉴别诊断中发挥作用。Glypican-3可能是比AFP更好的标志物，对评估PHC患者的治疗效果具有高特异性和敏感性。
