王志茹　刘庆波　赵文静

[摘要] 目的 探讨GP73对原发性肝癌的诊断价值。方法 免疫组化法检测肝癌组织、癌旁组织及正常肝脏组织中高尔基体糖蛋白73（golgiprotein-73，GP73）和甲胎蛋白（alpha-fetoprotein，AFP）的表达，ELISA法检测肝癌患者血清GP73和AFP浓度。结果 GP73蛋白在肝癌组织强表达，癌旁组织细胞浆表达较弱，正常肝脏组织无表达，58例肝癌组织中GP73阳性为55例，AFP阳性为40例，两者诊断肝癌的阳性率差异有统计学意义（P<0.05）；58例PHC患者GP73平均浓度为（238.1±121.6）ng/mL，42例GP73阳性，敏感性为72.4%；AFP平均浓度为（885.6±498.6） ng/mL，30例AFP阳性，敏感性为51.7%，GP73和AFP联合检测能将敏感性提高到85.9%（50/58）；PHC患者肿瘤大小之间、肿瘤个数之间血清GP73浓度无确切关系。结论 GP73是一个诊断PHC良好的血清标志物，其敏感性和特异性均较好，GP73和AFP联合检测可以提高早期肝癌的检出率。

[关键词] 高尔基体糖蛋白73；甲胎蛋白；原发性肝癌

[中图分类号] R735.7 [文献标识码] B [文章编号] 2095-0616（2014）10-125-04

[Abstract] Objective To evaluate the diagnostic value of golgiprotein 73 for primary liver cancer. Methods The immunohistochemical method was used to detect the expression of golgiprotein 73（GP73） and alpha-fetoprotein（AFP） in liver cancer tissue， para-cancer tissue and normal liver tissue. The ELISA method was used to detect the serum GP73 and AFP concentrations in the patients with liver cancer. Results GP73 had strong expression in liver cancer tissue， weak expression in cytoplasma of para-cancer tissue and no expression in normal liver tissue. Of the 58 cases of liver cancer tissue， 55 cases were positive GP73 expression and 40 cases were positive AFP expression， with statistically significant difference in the positive rate of liver cancer diagnosis between the two indicators（P<0.05）； The average GP73 concentration of 58 PHC patients was （238.1±121.6）ng/mL， of which 42 patients had positive GP73 expression， with the sensibility of 72.4%； The average AFP concentration was （885.6±498.6）ng/mL， of which 30 patients had positive AFP expression， with the sensibility of 51.7%. Combined GP73 and AFP detection can increase the sensibility to 85.9%（50/58）. The serum GP73 concentrations between the PHC patients with different tumor sizes and tumor numbers did not have accurate relationship. Conclusion GP73 is a good serum marker for the diagnosis of PHC and it has good sensibility and specificity. Combined GP73 and AFP detection can improve the detection rate of early liver cancer.

[Key words] Golgiprotein 73；Alpha-fetoprotein；Primary liver cancer

原发性肝癌（primary hepatic cancer，PHC）是临床上常见的恶性肿瘤。2011年《全球癌症统计》显示PHC的发病率居恶性肿瘤第5位，死亡率居第2位[1]。另有报道显示我国为PHC高发区，发病人数和死亡人数约占全球总数的55%以上[2]。PHC具有起病隐匿、恶性度高、进展快、转移早等临床特点，多数患者在病程早期多无临床症状，约70%～80%患者发现时已为肿瘤晚期，无法进行有效的根治治疗，而且PHC患者术后复发率高，预后差，生存期短，因此肝癌的早期诊断尤为重要[3]。1.1 标本来源和处理

肝癌组组、癌旁组织取自2012年1～12月吉林肝胆病医院收治的原发性肝癌手术切除的标本，其中男47例，女11例，年龄32～75岁，平均54岁，患者均经临床、影像学诊断符合《内科学》第12版中原发性肝癌的诊断标准[4]，术前均未接受过任何抗肿瘤治疗，术后病理证实为肝细胞癌。肝癌组织标本取自手术切除的无坏死癌组织，距癌组织标本取自大于2cm处无癌细胞浸润的癌旁组织，采用10%中性福尔马林固定，常规脱水，包埋，制备病理组织切片。……