【作者】 贾保昌；

【导师】 罗小玲；

【作者基本信息】 广西医科大学 ， 肿瘤学， 2012， 硕士

【摘要】 目的探讨血清高尔基体糖蛋白(GP73)对原发性肝癌(primary liver carcinoma PLC)(以下简称肝癌)的诊断价值及分析GP73和甲胎蛋白(AFP)联合检测对PLC诊断的临床意义,为PLC诊断提供一种新的有效检测手段。方法采用双抗体夹心酶联免疫定量测定方法检测144例PLC患者、50例肝硬化患者、100例乙型肝炎患者、50例其他恶性肿瘤患者、26例肝良性病变患者、84例HBV携带者和50例正常人对照组的血清GP73浓度。采用临床电化学发光法测定血清AFP作为参比。结果1.PLC组血清GP73水平与肝硬化组、乙型肝炎组、HBV携带者组、其他恶性肿瘤组、肝良性病变组和正常人对照组的血清GP73水平相比显著增高(168.22±1045.58vs149.81±1091.98、30.32±146.73、19.65±137.3930.05±147.35、28.58±143.27和13.98±8.74,P=0.041、0.000、0.000、0.000、0.000和0.000)。通过受试者工作特征(receiver operating characteristic, ROC)曲线设定GP73水平,GP73为64ng/mL作为诊断PLC的临界值切点(cut-off)时,GP73诊断PLC的敏感度和特异度达到最佳,分别为83.3%和88.3%。2.在PLC组,GP73诊断PLC的敏感度与AFP比较有统计学差异(83.3%vs72.2%,P=0.023),GP73诊断PLC的敏感度要高于AFP。3.联合检测血清GP73和AFP,诊断PLC的敏感度提高到94.4%,特异度为65.5%,敏感度显著高于GP73(83.3%)或AFP(72.2%)单项检测。结论1.GP73是一种敏感度更高、特异度更好的新的肝癌标志物,检测血清GP73水平对PLC诊断有较好的敏感度和特异度,均优于AFP。2.联合检测血清GP73和AFP可有效减少AFP阴性或低浓度肝癌的漏诊率,提高肝癌的检出率和诊断肝癌的准确性,是更有效的诊断肝癌的肿瘤标志物组合。更多还原

【Abstract】 OBJECTIVESTo explore the diagnostic value of serum GP73in the patient of primary liver carcinoma (PLC), discuss the diagnostic value of the joint roles of serum GP73and AFP in the diagnosis of PLC, and provide a new detection method for the diagnosis of PLC.METHODSELISA method was used to detect the serum level of GP73in144cases of PLC,50cases of hepatic cirrhosis,100cases of hepatitis,50cases of other malignant tumors,26cases of liver benign lesions,84cases of hepatitis carriers and50cases of healthy volunteers (as the controls). The electrochemical luminescence method was used to detect the serum level of AFP of the all, and the level of AFP was as a comparison.RESULTS1. The level of serum AFP and GP73in the group of PLC were significantly higher than that of hepatic cirrhosis, hepatitis, other malignant tumors, liver benign lesions, hepatitis carriers and healthy volunteers (as the controls)(168.22±1045.58vs149.81±1091.98、30.32±146.73、19.65±137.39、 30.05±147.35、28.58±143.27和13.98±8.74,P=0.041、0.000、0.000、0.000、0.000和0.000), the critical value for GP73was determined to be64.4ng/mL through the ROC curves, under the critical value the sensitivity and specificity of the GP73was83.3%and88.3%, and these were the best.2. The difference of GP73and AFP in the group of PLC was statistically significant (83.3%vs72.2%, P=0.023).3. The diagnostic sensitivity of the joint roles of serum GP73and AFP was increased to94.4%, and the specificity up to65.5%. The Sensitivity of the joint roles of the both was significantly higher than one single detection of GP73(83.3%) or AFP (72.2%).CONCLUSION1. The GP73was one of the best liver tumor markers, which had better sensitivity and specificity than AFP. The diagnostic sensitivity and specificity of the serum GP73in the diagnosis of PLC was better than AFP.2. The joint roles of serum GP73and AFP could reduce effectively the missed diagnosis and of PLC whose AFP was negative or low concentration, it could improve the detection rate and the diagnosis accuracy of PLC, it was one of the best effective diagnosis combination in tumor markers of PLC.更多还原