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目的检测原发性肝细胞癌(HCC)患者射频治疗前后血清中磷脂酰肌醇蛋白聚糖3(GPC3)的含量,初步探讨其在疗效评价中的临床应用价值。方法采用酶联免疫吸附法检测59例HCC患者、35例肝硬化患者、对照组30名健康者血清中GPC3的表达,其中30例HCC患者经射频治疗,对射频治疗前与治疗后1d、5d、30d血清中GPC3含量进行比较,Logistic回归模型进行HCC患者射频治疗后GPC3表达水平波动的危险因素分析。结果 HCC患者血清GPC3含量明显高于肝硬化患者和健康对照组人群,对比三组间的差异有统计学意义(P均<0.01),HCC患者射频治疗后不同时间点GPC3含量较治疗前明显下降(P<0.01),快速复发患者GPC3含量有显著升高波动(P<0.01)。结论 GPC3含量在HCC中表达显著高于肝硬化及正常对照组,特异性好,与AFP表达无明显相关性,联合诊断更有利于提高HCC的诊断敏感性,射频消融治疗后不同阶段GPC3均有不同程度降低,GPC3浓度的变化与快速复发有关,在疗效评估及预后判断有一定临床价值。
Objective To detect the content of glypican 3 (GPC3) in patients with primary hepatocellular carcinoma (HCC) before and after radiofrequency ablation, and to explore its clinical value in the evaluation of curative effect. Methods The serum levels of GPC3 in 59 patients with HCC, 35 patients with cirrhosis and 30 healthy controls were detected by enzyme-linked immunosorbent assay. Thirty patients with HCC were treated with radiofrequency ablation before radiofrequency ablation and 1d, 5d , 30d Serum GPC3 levels were compared, Logistic regression model of HCC patients after radiofrequency ablation GPC3 expression levels of risk factors. Results The serum level of GPC3 in patients with HCC was significantly higher than that in patients with cirrhosis and healthy controls (P <0.01). GPC3 levels in HCC patients at different time points after radiofrequency ablation were significantly lower than those before treatment (P <0.01), GPC3 content in patients with rapid recurrence fluctuated significantly (P <0.01). Conclusion The expression of GPC3 in HCC was significantly higher than that in cirrhosis and normal controls. The specificity of GPC3 was not correlated with the expression of AFP. The combined diagnosis of HCC was more helpful to improve the diagnostic sensitivity of HCC. After the radiofrequency ablation, To varying degrees, changes in GPC3 concentration and rapid relapse, in the evaluation of the efficacy and prognosis of a certain clinical value.