论文部分内容阅读
目的探讨定量测定血清高尔基体蛋白73(GP73)的临床意义。方法采用双抗体夹心酶联免疫吸附法(ELISA)测定肝癌治疗前、肝癌介入术后、肝癌切除术后、肝移植术后、肝癌复发、乙肝肝硬化、慢性乙型肝炎、乙肝携带者、慢性丙型肝炎、脂肪肝以及健康体检血清标本中的GP73浓度。结果肝癌治疗前病例组中GP73的ROC曲线下面积为0.983,敏感性和特异性分别为96.8%和93.9%;对比肝癌治疗前,介入术后GP73浓度下降(P<0.001),肝癌切除和肝移植术后GP73浓度下降(P<0.001),肝癌复发伴随GP73浓度升高。与健康体检组比较,GP73浓度在肝硬化病例组中显著升高(P<0.001),但是低于肝癌治疗前病例组中GP73浓度(P<0.001)。在慢性乙型肝炎、乙肝携带者、脂肪肝病例组中均可检测到GP73,但显著低于肝癌治疗前病例组(P<0.001)。GP73浓度与肝癌分期的相关性不明显。6种非肝脏恶性肿瘤标本中GP73浓度显著低于未治疗的肝癌标本(P<0.001)。GP73在丙肝相关肝病的浓度均显著高于乙肝相关肝病(P<0.001)。结论 GP73可作为辅助临床早期诊断肝癌的一种标志物,对肝癌术后的复发及肝硬化的进展也有监测作用。
Objective To investigate the clinical significance of quantitative determination of serum Golgi protein 73 (GP73). Methods Before the treatment of hepatocellular carcinoma with double antibody sandwich enzyme-linked immunosorbent assay (ELISA), the patients with liver cancer after interventional therapy, liver cancer resection, liver transplantation, liver cancer recurrence, hepatitis B cirrhosis, chronic hepatitis B, hepatitis B carriers, chronic Hepatitis C, fatty liver, and serum levels of GP73 in health examination. Results Before treatment, the area under the ROC curve of GP73 was 0.983 and the sensitivity and specificity were 96.8% and 93.9%, respectively. Before the treatment, the GP73 concentration was decreased (P <0.001) The GP73 concentration decreased after transplantation (P <0.001), and the recurrence of hepatocellular carcinoma accompanied with the increase of GP73 concentration. Compared with the healthy group, the concentration of GP73 was significantly increased in patients with cirrhosis (P <0.001), but lower than that of GP73 in patients with liver cancer before treatment (P <0.001). GP73 was detected in chronic hepatitis B, hepatitis B carriers and fatty liver cases, but was significantly lower than that of the pre-treatment liver cancer patients (P <0.001). The correlation between GP73 concentration and liver cancer staging is not obvious. The GP73 concentrations in 6 non-hepatic malignancies were significantly lower than those in untreated HCC (P <0.001). The concentrations of GP73 in hepatitis C-related liver disease were significantly higher than those in hepatitis B-related liver disease (P <0.001). Conclusion GP73 can be used as a marker for early diagnosis of hepatocellular carcinoma in clinic, and it can also monitor the recurrence of hepatocellular carcinoma and the progress of cirrhosis.