薛 冰 景博琼 徐 笛



GP73在不同类型肝病中的应用价值

薛 冰 景博琼 徐 笛

【摘要】目的 探讨高尔基体蛋白73（GP73）在慢性乙肝、肝硬化、肝细胞癌患者的表达水平。方法 采用酶联免疫定量测定法和电化学发光法检测63例原发性肝癌、77例肝硬化、83例慢性乙肝患者和75例健康人的血清中GP73、AFP含量。非正态分布数据多组间比较采用KW单因素方差分析，组间比较采用曼-惠特尼U检验。率的比较用卡方检验。P＜0.05为差异有统计学意义。结果 GP73的含量在PHC组、肝硬化组、慢性乙肝组和健康对照组的总体分布不同（H=186.57，P＜0.01），进一步两两比较，PHC组含量均高于其它各组（P＜0.01）。以肝硬化组为参照，绘制GP73诊断PHC的ROC曲线，其AUC为0.867，敏感度90.48%、特异度66.23%。结论 GP73对原发性肝癌的诊断有较高的灵敏度，是一种有价值的肿瘤标志物，做为AFP诊断PHC的有效补充，可以提高PHC的早期诊断率。

【关键词】高尔基体蛋白73；甲胎蛋白；原发性肝癌

Objective To explor golgi protein 73（GP73）in patients with chronic hepatitis B，liver cirrhosis and hepatocellular carcinoma（HCC）of expression level. Methods The levels of GP73 and AFP in serum of 63 cases of primary liver cancer，77 cases of cirrhosis，83 cases of chronic hepatitis B and 75 healthy persons were detected by enzyme linked immunosorbent assay and electrochemical luminescence assay. Comparison of non-normally distributed data was made by Kruskal-Wallis single factor ANOVA test，and multiple comparisons were made by Mann-Whitney U tset.Comparison of rates was made by chi-square test. P＜0.05 was considered significantly different. Results GP73 content in the PHC group，cirrhosis group，chronic hepatitis B group and healthy control group of the overall distribution of different（H=186.57，P＜0.01），further paired comparisonn，PHC group content was higher than other groups（P＜0.01）. In the cirrhosis group，the ROC curve of GP73 was drawn，and the AUC was 0.867，the sensitivity was 90.48% and the specificity was 66.23%. Conclusion GP73 has high sensitivity to the diagnosis of primary liver cancer. It is a valuable tumor marker，and it can be an effective complement to AFP diagnosis PHC. It can improve the early diagnosis rate of PHC.

【Key words】Golgi protein 73，Alpha-fetoprotein，Primary hepatocellular carcinoma

统计至2012年底，恶性肿瘤为我国城镇人口死亡率第二高疾病，死亡率第二高的恶性肿瘤即肝癌［1］。我国肝癌多由乙肝病毒感染逐渐演变为慢性乙肝、肝硬化、肝细胞癌。原发性肝癌（PHC）早期无典型临床表现，诊断后多为晚期，错失宝贵的治疗时间，早期准确诊断PHC对挽救患者生命具重要意义。甲胎蛋白（AFP）是PHC诊断的经典肿瘤标志物，但是仍有相当一部分AFP阴性PHC漏诊，有研究发现高尔基体蛋白73（GP73）具有作为PHC诊断肿瘤标志物的价值［2］。本文通过测定GP73在不同临床类型肝病中的浓度，分析GP73对肝癌早期诊断的临床价值。

1　对象与方法

1.1对象