CAJ | 학술논문

目的：探讨高尔基体糖蛋白73（ GP73）在腹腔积液中的含量情况，并研究腹腔积液中GP73和甲胎蛋白（ AFP）检测在腹腔积液鉴别诊断中的价值。方法2012年11月至2013年11月从新疆医科大学附属肿瘤医院检验科收集96份恶性和35份良性腹腔积液样本及对应患者同一时段的血清样本，ELISA检测血清和腹腔积液中的GP73含量，电化学发光法检测腹腔积液中的AFP含量，采用受试者工作特征曲线法（ ROC曲线）评价GP73和AFP诊断腹腔积液性质的应用价值。结果在良性组，腹腔积液中GP73的含量（16.06±9.53） ng/ml和血清中GP73的含量（13.69±8.87） ng/ml差异有统计学意义（t＝5.026，P＜0.001），同时具有较好的线性相关性（r＝0.966，P＜0.001）。在恶性组，腹腔积液中的GP73含量（28.37±12.02） ng/ml和血清中GP73含量（23.31±9.46） ng/ml差异有统计学意义（t＝10.641，P＜0.001），也具有较好的线性相关性（r＝0.933，P＜0.001）。恶性腹腔积液组GP73含量与良性腹腔积液组GP73含量差异有统计学意义（t ＝5.375，P＜0.001）。 GP73、AFP、GP73*AFP（ AFP与GP73乘积）诊断恶性腹腔积液的临界值分别是17.1 ng/ml、13.1 ng/ml和321；曲线下面积分别是0.795、0.753和0.902，其中GP73*AFP的曲线下面积最大；三者对应的敏感度分别是89.6％（86/96）、88.5％（85/96）和86.4％（83/96）；特异度分别是60.0％（21/35）、54.2％（19/35）和85.7％（30/35）。结论腹腔积液标本中含有具有临床检测意义的GP73浓度；相比GP73或者AFP，GP73*AFP是对良恶性腹腔积液鉴别诊断的较好指标。（中华检验医学杂志，2014，37：683-686）
목적：탐토고이기체당단백73（ GP73）재복강적액중적함량정황，병연구복강적액중GP73화갑태단백（ AFP）검측재복강적액감별진단중적개치。방법2012년11월지2013년11월종신강의과대학부속종류의원검험과수집96빈악성화35빈량성복강적액양본급대응환자동일시단적혈청양본，ELISA검측혈청화복강적액중적GP73함량，전화학발광법검측복강적액중적AFP함량，채용수시자공작특정곡선법（ ROC곡선）평개GP73화AFP진단복강적액성질적응용개치。결과재량성조，복강적액중GP73적함량（16.06±9.53） ng/ml화혈청중GP73적함량（13.69±8.87） ng/ml차이유통계학의의（t＝5.026，P＜0.001），동시구유교호적선성상관성（r＝0.966，P＜0.001）。재악성조，복강적액중적GP73함량（28.37±12.02） ng/ml화혈청중GP73함량（23.31±9.46） ng/ml차이유통계학의의（t＝10.641，P＜0.001），야구유교호적선성상관성（r＝0.933，P＜0.001）。악성복강적액조GP73함량여량성복강적액조GP73함량차이유통계학의의（t ＝5.375，P＜0.001）。 GP73、AFP、GP73*AFP（ AFP여GP73승적）진단악성복강적액적림계치분별시17.1 ng/ml、13.1 ng/ml화321；곡선하면적분별시0.795、0.753화0.902，기중GP73*AFP적곡선하면적최대；삼자대응적민감도분별시89.6％（86/96）、88.5％（85/96）화86.4％（83/96）；특이도분별시60.0％（21/35）、54.2％（19/35）화85.7％（30/35）。결론복강적액표본중함유구유림상검측의의적GP73농도；상비GP73혹자AFP，GP73*AFP시대량악성복강적액감별진단적교호지표。（중화검험의학잡지，2014，37：683-686）
Objective To investigate the concentration of Golgi glycoprotein 73(GP73) in ascites, then study the value of GP73 and alpha fetal protein(AFP)in the differential diagnosis of ascites.Methods Totally 96 malignant ascites specimens , 35 benign ascites specimens and their paired serum specimens were collected in the Tumor Hospital Affiliated to Xinjiang Medical University from November 2012 to November 2013.GP73 in serum and ascites were detected by ELISA and AFP in ascites was measured by electrochemical luminescence.The application values of GP 73 and AFP were evaluated through ROC curve.Results In benign ascites group , the difference of GP73 between the ascites ( 16.06 ±9.53 ) ng/ml and the serum (13.69 ±8.87) ng/ml was statistically significant (t=5.026,P<0.001), which showed a good linear correlation (r=0.966,P<0.001).In malignant ascites group, the difference between the ascites (28.37 ±12.02) ng/ml and the serum (16.06 ±9.53) ng/ml was statistically significant (t=10.641,P<0.001), and also showed a good linear correlation (r=0.933,P<0.001).The cutoff values of GP73, AFP and GP73*AFP (GP73 multiplied AFP) for diagnosing the malignant ascites were 17.1 ng/ml, 13.1 ng/ml and 321.The area under ROC curve ( AUC) were 0.795, 0.753 and 0.902 respectively.The AUC of GP73*AFP is the largest.The sensitivity of three index diagnosing the ascites , were 89.6%( 86/96 ) , 88.5%(85/96) and 86.4%(83/96); and the specificity were 60.0%(21/35), 54.2%(19/35) and 85.7%( 30/35 ) respectively.Conclusions Detection of GP73 in ascites specimens has clinical value , GP73*AFP was the best indicators for differential diagnosis of benign and malignant ascites compared to GP73 and AFP.