中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2012年
10期
780-784
,共5页
陈建国%朱源荣%陆卫中%张永辉%陆建华
陳建國%硃源榮%陸衛中%張永輝%陸建華
진건국%주원영%륙위중%장영휘%륙건화
癌,肝细胞%高尔基体%糖蛋白类%甲胎蛋白类%肝炎表面抗原,乙型%诊断
癌,肝細胞%高爾基體%糖蛋白類%甲胎蛋白類%肝炎錶麵抗原,乙型%診斷
암,간세포%고이기체%당단백류%갑태단백류%간염표면항원,을형%진단
Carcinoma,hepatocellular%Golgi apparatus%Glycoproteins%AFP%HBsAg%Diagnosis
目的 探讨高尔基体糖蛋白73 (GP73)在不同人群中的检测水平和范围. 方法 在启东某社区35 ～ 69岁人群中,用HBsAg检测筛查12378人,随机抽取其中十分之一(受检者检测号末尾为“0”者)组成“自然人群组”(1227人);12378人中的所有HBsAg携带者组成“阳性组”(1025人)；在HBsAg非携带者中随机抽取十分之一组成“阴性组”(1132人).采用ELISA法检测以上各组血清GP73与AFP,评价其分布以及中位值(50％百分位数)和95％临界值.对HBsAg携带者及非携带者人群进行了2年的随访并观察肝癌发生率的差别.采用stata软件进行检测水平分布的偏度系数(Skewness)和峰度系数(Kurtosis)检验,并进行率差异的显著性检验. 结果 GP73水平在HBsAg携带者、HBsAg非携带者和自然人群中的分布均为正偏态分布,50％百分位值(中位值)分别为67μg/L、54 μg/L及55 μg/L,95％百分位值分别为174 μg/L、108μg/L及114μg/L.HBsAg携带者中GP73高于均值者的AFP阳性率为7.23％ (37/512),低于均值者的AFP阳性率为0.78％ (4/513),差异有统计学意义(P＜0.01).经2年的随访,HBsAg携带者中GP73≥67μg/L的512例中,23例发生肝癌(4.49％),而＜67μg/L的513例中1例发生肝癌(0.19％),RR=23.6.但在HBsAg非携带者中,不管GP73水平高低,未见肝癌的发生. 结论 GP73在HBsAg携带者中的检出水平较高；用GP73作为标志物对HBsAg携带者人群进行随访,可能有助于肝癌的早期发现.
目的 探討高爾基體糖蛋白73 (GP73)在不同人群中的檢測水平和範圍. 方法 在啟東某社區35 ～ 69歲人群中,用HBsAg檢測篩查12378人,隨機抽取其中十分之一(受檢者檢測號末尾為“0”者)組成“自然人群組”(1227人);12378人中的所有HBsAg攜帶者組成“暘性組”(1025人)；在HBsAg非攜帶者中隨機抽取十分之一組成“陰性組”(1132人).採用ELISA法檢測以上各組血清GP73與AFP,評價其分佈以及中位值(50％百分位數)和95％臨界值.對HBsAg攜帶者及非攜帶者人群進行瞭2年的隨訪併觀察肝癌髮生率的差彆.採用stata軟件進行檢測水平分佈的偏度繫數(Skewness)和峰度繫數(Kurtosis)檢驗,併進行率差異的顯著性檢驗. 結果 GP73水平在HBsAg攜帶者、HBsAg非攜帶者和自然人群中的分佈均為正偏態分佈,50％百分位值(中位值)分彆為67μg/L、54 μg/L及55 μg/L,95％百分位值分彆為174 μg/L、108μg/L及114μg/L.HBsAg攜帶者中GP73高于均值者的AFP暘性率為7.23％ (37/512),低于均值者的AFP暘性率為0.78％ (4/513),差異有統計學意義(P＜0.01).經2年的隨訪,HBsAg攜帶者中GP73≥67μg/L的512例中,23例髮生肝癌(4.49％),而＜67μg/L的513例中1例髮生肝癌(0.19％),RR=23.6.但在HBsAg非攜帶者中,不管GP73水平高低,未見肝癌的髮生. 結論 GP73在HBsAg攜帶者中的檢齣水平較高；用GP73作為標誌物對HBsAg攜帶者人群進行隨訪,可能有助于肝癌的早期髮現.
목적 탐토고이기체당단백73 (GP73)재불동인군중적검측수평화범위. 방법 재계동모사구35 ～ 69세인군중,용HBsAg검측사사12378인,수궤추취기중십분지일(수검자검측호말미위“0”자)조성“자연인군조”(1227인);12378인중적소유HBsAg휴대자조성“양성조”(1025인)；재HBsAg비휴대자중수궤추취십분지일조성“음성조”(1132인).채용ELISA법검측이상각조혈청GP73여AFP,평개기분포이급중위치(50％백분위수)화95％림계치.대HBsAg휴대자급비휴대자인군진행료2년적수방병관찰간암발생솔적차별.채용stata연건진행검측수평분포적편도계수(Skewness)화봉도계수(Kurtosis)검험,병진행솔차이적현저성검험. 결과 GP73수평재HBsAg휴대자、HBsAg비휴대자화자연인군중적분포균위정편태분포,50％백분위치(중위치)분별위67μg/L、54 μg/L급55 μg/L,95％백분위치분별위174 μg/L、108μg/L급114μg/L.HBsAg휴대자중GP73고우균치자적AFP양성솔위7.23％ (37/512),저우균치자적AFP양성솔위0.78％ (4/513),차이유통계학의의(P＜0.01).경2년적수방,HBsAg휴대자중GP73≥67μg/L적512례중,23례발생간암(4.49％),이＜67μg/L적513례중1례발생간암(0.19％),RR=23.6.단재HBsAg비휴대자중,불관GP73수평고저,미견간암적발생. 결론 GP73재HBsAg휴대자중적검출수평교고；용GP73작위표지물대HBsAg휴대자인군진행수방,가능유조우간암적조기발현.
Objective To survey the levels of Golgi glycoprotein (GP73),a hepatocellular carcinoma (HCC) marker,in residents of Qidong and determine the correlation of detected GP73 concentration ranges with outcome at two-year follow-up.Methods A total of 12,378 individuals (age range:35-69 years old)from Qidong were enrolled in the study.All participants were tested for hepatitis B virus (HBV) by detecting hepatitis B surface antigen (HBsAg) in serum.One-tenth of the participants were assigned to a stratifiedrandom sample group (those with identification numbers ending with "0") to represent a "subgroup of the natural population" (HBsAgPop,n =1227).All HBsAg carriers were stratified as a "subgroup of positivity"(HBsAgPve,n=1025).One-tenth of all HBsAg-negative individuals were assigned to a stratified-random sample group to represent a "subgroup of negativity" (HBsAgNve,n =1132).Enzyme-linked immunoassay was used to measure the serum GP73 and alpha-fetoprotein (AFP) levels; the distribution,medians (50th percentile),and 95th percentiles of GP73 were determined for the three subgroups.A two-year follow-up was carried out to observe the differential incidence of HCC between the HBsAgPve and HBsAgNve subgroups.Results A positively skewed distribution of the GP73 values was observed for all three subgroups.The medians for HBsAgPve,HBsAgNve,and HBsAgPop were 67μg/L,54 μg/L,and 55 μg/L; the 95th percentiles were 174 μg/L,108 μg/L,and 114 μg/L,respectively.The AFP positivity rates were 7.23％ (37/512)for carriers whose GP73 values were above the median level and 0.78％ (4/513) for carriers with GP73 values below the median level,with a highly significant difference between the two (P＜ 0.01).A the two-year follow-up,23 (4.49％) of the 512 carriers with GP73 ≥ 67 μg/L had developed HCC,while only one patient (0.19％) of the 513 carriers with GP73 ＜ 67 μg/L developed HCC,which yielded a relative risk value of 23.6.In the non-carriers,no HCC cases had occurred,regardless of serum GP73 level.Conclusion Serum GP73 has a higher potential as a diagnostic/prognostic marker of HCC in individuals with HBsAg positivity.In follow-up of HBsAg carriers,GP73 may help in the early detection of liver cancer.
