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目的探讨高尔基体糖蛋白(GP73)在乙型肝炎相关性肝细胞癌(HCC)患者血清及肝组织表达水平的变化及其意义。方法采用酶联免疫吸附试验(ELISA)检测慢性乙型肝炎患者20例、乙型肝炎肝硬化患者20例、乙型肝炎相关性HCC患者40例以及健康对照者10名血清GP73含量,绘制并计算ROC曲线下面积以及评价GP73对HCC的诊断价值;同时,对其中部分患者的肝组织进行免疫组织化学法,检测GP73的表达水平。结果乙型肝炎相关性HCC患者血清GP73含量为(204.03±90.69)ng/ml,均明显高于健康对照组、慢性乙型肝炎和肝硬化患者(P<0.05);慢性乙型肝炎、肝硬化患者血清GP73含量也显著高于健康对照组(P<0.05)。GP73诊断HCC的灵敏度和特异度分别为77.5%和84.0%;阳性预测值和阴性预测值分别为79.5%和82.4%;同时,GP73诊断HCC的ROC曲线下面积为0.81,其ROC曲线在AFP的ROC曲线左上方;并且对AFP低值的HCC也有一定的诊断价值,GP73升高不受AFP影响。另一方面,肝组织中GP73呈棕黄色或深棕黄色染色,主要位于细胞质,HCC患者肝脏癌组织中GP73呈高表达,与肝硬化组和慢性乙型肝炎组比较,差异均有统计学意义(P<0.05)。结论检测GP73有助于HCC的诊断和鉴别,可能提高目前对HHC的诊断率。
Objective To investigate the changes and significance of GP73 in serum and liver tissues of patients with hepatocellular carcinoma (HCC). Methods 20 cases of chronic hepatitis B, 20 cases of hepatitis B cirrhosis, 40 cases of hepatitis B-related HCC and 10 healthy people were detected by enzyme linked immunosorbent assay (ELISA) Area under the ROC curve, and to evaluate the diagnostic value of GP73 for HCC; meanwhile, the liver tissue of some patients was immunohistochemically detected to detect the expression level of GP73. Results The serum level of GP73 in patients with hepatitis B-related HCC was (204.03 ± 90.69) ng / ml, which were significantly higher than those in healthy controls, patients with chronic hepatitis B and cirrhosis (P <0.05), chronic hepatitis B, cirrhosis Patients with serum GP73 levels were also significantly higher than the healthy control group (P <0.05). The sensitivity and specificity of GP73 in the diagnosis of HCC were 77.5% and 84.0%, respectively. The positive predictive value and negative predictive value were 79.5% and 82.4%, respectively. Meanwhile, the area under the ROC curve of GP73 was 0.81. The ROC curve of GP73 in AFP ROC curve at the top left; and AFP low value of HCC also have some diagnostic value, GP73 increased from AFP. On the other hand, GP73 in liver tissue was stained brown or dark brown, mainly in the cytoplasm. The expression of GP73 in liver cancer tissues of HCC patients was highly expressed, which was significantly different from those in cirrhosis and chronic hepatitis B (P <0.05). Conclusion The detection of GP73 contributes to the diagnosis and differentiation of HCC, which may improve the current diagnosis of HHC.