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目的探析血清蛋白标记物早期诊断肝癌可行性及临床应用价值。方法入选60例肝癌患者(A组)、35例肝硬化患者(B组)、15例其他疾病(C组)、15例健康者(对照组)为研究对象,采集静脉血检测甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体膜蛋白73(CP73),并分析其和肿瘤直径、巴萨罗那(BCLC)分级相关性。结果 A组血清中AFP、AFP-L3、GP73含量均明显高于其余3组(P<0.05)。肿瘤直径和血清AFP和GP73水平无明显相关性,和血清AFP-L3存在明显相关性;肿瘤数量和血清AFP、AFP-L3、CP73无明显相关性。BCLC分级和AFP、AFP-L3呈正相关,AFP敏感度为85.7%,特异度为72.9%;AFP-L3敏感度为58.0%,特异度为87.6%;GP73敏感度为69.7%,特异度为76.7%。平行试验联合检测法可提高检测的敏感性及阴性预值;系列试验联合检测法提高特异性和阳性预测值。结论血清AFP、AFP-L3、CP73联合检测,利用阳性互补性,可明显提高肝癌诊断准确性。
Objective To investigate the feasibility and clinical value of serum protein markers for the early diagnosis of liver cancer. Methods A total of 60 patients with liver cancer (group A), 35 patients with liver cirrhosis (group B), 15 patients with other diseases (group C) and 15 healthy subjects (control group) were enrolled in this study. Venous blood was collected to detect alpha-fetoprotein AFP), AFP-L3, and Golgi membrane protein 73 (CP73) were detected by immunohistochemistry and analyzed for tumor grade and BCLC grade. Results The levels of AFP, AFP-L3 and GP73 in group A were significantly higher than those in other three groups (P <0.05). There was no significant correlation between tumor diameter and serum AFP and GP73 levels, but significant correlation with serum AFP-L3. There was no significant correlation between tumor size and serum AFP, AFP-L3 and CP73. The BCLC grade was positively correlated with AFP and AFP-L3. The AFP sensitivity was 85.7% and the specificity was 72.9%. The AFP-L3 sensitivity was 58.0% and the specificity was 87.6%. The GP73 sensitivity was 69.7% and the specificity was 76.7 %. Parallel test combined detection method can improve the detection sensitivity and negative predictive value; series of tests combined detection method to improve the specificity and positive predictive value. Conclusion Serum AFP, AFP-L3, CP73 combined detection, the use of positive complementarity, can significantly improve the diagnostic accuracy of liver cancer.