CAJ | 학술논문

目的探讨血清去γ-羧基凝血酶原(DCP)、高尔基体蛋白73(GP73)、热反应蛋白70(HSP70)水平对肝癌的诊断价值.方法收集2013年1至7月桂林医学院附属医院肝癌患者35例、健康对照者35名.采用电化学发光法和酶联免疫吸附法定量检测各组血清DCP、GP73、HSP70和甲胎蛋白(A FP)水平.结果健康对照组AFP、DCP、GP73水平分别为1.240(0.605 ～ 5.310) μg/L、104.606(0.000 ～4 138.770)pg/ml、30.770(16.343 ～ 87.453) ng/ml,肝癌组分别为13.780(1.140 ～8 487.000)μg/L、3 213.953(2.510 ～53 994.602) pg/ml、76.838(24.500 ～ 232.875) ng/ml,均明显高于健康对照组,差异有统计学意义(U=134.50、258.00、168.00,均P＜0.01);2组血清均未能检测出HSP70.血清DCP、GP73用于肝癌诊断的ROC曲线下面积分别为0.789、0.863,以2 939.4 pg/ml、41.3 ng/ml作为DCP、GP73诊断肝癌的临界值,则DCP诊断肝癌的敏感度为54.3％,特异度为97.1％,GP73诊断肝癌的敏感度为85.7％,特异度为74.3％.本研究中以常规20 μg/L作为血清AFP诊断的临界值,其敏感度仅为45.7％,特异度为100％,准确度为72.9％.联合检测中,GP73/AFP诊断肝癌的敏感度为88.6％,特异度为74.3％,准确度为81.4％;GP73/DCP/AFP诊断肝癌的敏感度为91.4％,特异度为71.4％,准确度为81.4％.结论 GP73联合AFP或GP73、DCP联合AFP检测可提高肝癌早期诊断的敏感度及准确度,建议将GP73、DCP及AFP的联合检测应用于肝癌的早期血清学诊断.
목적 탐토혈청거γ-최기응혈매원(DCP)、고이기체단백73(GP73)、열반응단백70(HSP70)수평대간암적진단개치.방법 수집2013년1지7월계림의학원부속의원간암환자35례、건강대조자35명.채용전화학발광법화매련면역흡부법정량검측각조혈청DCP、GP73、HSP70화갑태단백(A FP)수평.결과 건강대조조AFP、DCP、GP73수평분별위1.240(0.605 ～ 5.310) μg/L、104.606(0.000 ～4 138.770)pg/ml、30.770(16.343 ～ 87.453) ng/ml,간암조분별위13.780(1.140 ～8 487.000)μg/L、3 213.953(2.510 ～53 994.602) pg/ml、76.838(24.500 ～ 232.875) ng/ml,균명현고우건강대조조,차이유통계학의의(U=134.50、258.00、168.00,균P＜0.01);2조혈청균미능검측출HSP70.혈청DCP、GP73용우간암진단적ROC곡선하면적분별위0.789、0.863,이2 939.4 pg/ml、41.3 ng/ml작위DCP、GP73진단간암적림계치,칙DCP진단간암적민감도위54.3％,특이도위97.1％,GP73진단간암적민감도위85.7％,특이도위74.3％.본연구중이상규20 μg/L작위혈청AFP진단적림계치,기민감도부위45.7％,특이도위100％,준학도위72.9％.연합검측중,GP73/AFP진단간암적민감도위88.6％,특이도위74.3％,준학도위81.4％;GP73/DCP/AFP진단간암적민감도위91.4％,특이도위71.4％,준학도위81.4％.결론 GP73연합AFP혹GP73、DCP연합AFP검측가제고간암조기진단적민감도급준학도,건의장GP73、DCP급AFP적연합검측응용우간암적조기혈청학진단.
Objective To analyze the clinical value of the detection of serum desgamma carboxy prothrombin (DCP),golgi glycoprotein 73 (GP73),heat-shock protein 70 (HSP70) in primary hepatic carcinoma (PHC) diagnosis.Methods Enzyme-1inked immunosorbent assay and electrochemiluminescence immunoassay were used to detect the serum DCP,GP73,HSP70 and α-fetoprotein (AFP) levels in 35 PHC patients and 35 healthy controls.Results AFP,DCP and GP73 levels in PHC patients were 13.780(1.140-8 487.000) μg/L,3 213.953 (2.510-53 994.602) pg/ml and 76.838 (24.500-232.875) ng/ml respectively,significantly higher than those in healthy controls (1.240 (0.605-5.310) μg/L,104.610 (0.000-4 138.770) pg/ml and 30.770(16.343-87.453) ng/ml,U value were 134.50,258.00 and 168.00,all P ＜0.01) ; HSP70 could not be detected in any objects.The area under the ROC curve of DCP or GP73 was 0.789,0.863 respectively.The sensitivity and specificity to PHC diagnosis were 54.3％ and 97.1％ by DCP (2 939.4 pg/ml as cut-off value),85.7％ and 74.3％ by GP73 (41.3 ng/ml as cut-off value),45.7％ and 100％ by AFP (20 μg/L as cut-off value).In combined detection the sensitivity,specificity and accuracy were 88.6％,74.3％,81.4％ by GP73/AFP and 91.4％,71.4％,81.4％ by GP73/DCP/AFP.Conclusion GP73,DCP are new effective markers in the diagnosis of PHC,and the combined detection of GP73,DCP and AFP can improve the diagnosis value of PHC.