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目的评价磷酯酰肌醇蛋白聚糖3(gpc3)、高尔基体蛋白73(gp73)的检测水平与常规MR/CT对早期原发性肝癌(PHC)的诊断价值。方法对39例PHC、31例肝硬化患者,基线时收集外周血,采用ELISA法检测血清gpc3、gp73,并与MR/CT作对照。结果PHC组:gpc3(15.80±3.86)μg/L、gp73(107.46±29.50)ng/ml,肝硬化组:gpc3(7.51±1.38)μg/L、gp73(65.09±17.23)ng/ml;PHC组gpc3、gp73测量值高于肝硬化组(P<0.01);gpc3诊断PHC的截断值>9.3μg/L,受试者工作特征曲线下面积(AUC)=0.956,灵敏度为89.74%,特异度为96.77%,阳性预测值为97.20%,阴性预测值为88.20%,约登指数为0.8652,阳性似然比(+LR):27.82,阴性似然比(-LR):0.11;gp73诊断PHC的截断值>77.68ng/ml,AUC=0.937,灵敏度为92.31%,特异度为83.87%,阳性预测值为87.80%,阴性预测值为89.70%,约登指数0.7618,+LR:5.72,-LR:0.09。结论 gpc3、gp73的诊断灵敏度显著优于常规的MR/CT(70.00%),gpc3、gp73的特异度与常规的MR/CT(98.00%)相近,因此gpc3、gp73能够作为诊断早期PHC的指标。
Objective To evaluate the diagnostic value of gpc3, gp73 and routine MR / CT in the diagnosis of early stage primary liver cancer (PHC). Methods Thirty-nine patients with PHC and 31 patients with cirrhosis were collected at baseline. Serum gpc3 and gp73 were detected by ELISA, and compared with MR / CT. Results In the PHC group, gpc3 (15.80 ± 3.86) μg / L and gp73 (107.46 ± 29.50) ng / ml, cirrhosis group: gpc3 (7.51 ± 1.38) μg / L and gp73 (P <0.01). The cut-off value of gpc3 for PHC was> 9.3μg / L, the area under the working characteristic curve (AUC) was 0.956, the sensitivity was 89.74% and the specificity was 96.77%, positive predictive value was 97.20%, negative predictive value was 88.20%, Youden index was 0.8652, positive likelihood ratio (+ LR): 27.82, negative likelihood ratio (-LR): 0.11; A positive predictive value of 87.80%, a negative predictive value of 89.70%, a Youden index of 0.7618, a + LR of 5.72, a -LR of 0.09 . Conclusion The diagnostic sensitivity of gpc3 and gp73 is significantly better than that of conventional MR / CT (70.00%). The specificity of gpc3 and gp73 is similar to that of conventional MR / CT (98.00%). Therefore, gpc3 and gp73 can be used as indicators for early diagnosis of PHC.