血清检测Glypican-3对原发性肝细胞癌诊断及疗效评估的临床意义

发布时间：2018-03-16 18:09

本文选题：原发性肝细胞肝癌　切入点：肿瘤标志物　出处：《南方医科大学学报》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨血清检测磷酯酰肌醇蛋白聚糖-3(GPC3)对原发性肝细胞癌(PHC)诊断及疗效评估的临床意义。方法采用双抗夹心ELISA法,对60例PHC,60例转移性肝癌,50例肝硬化,50例慢性病毒性肝炎,20例肝囊肿,20例脂肪肝,20例肝血管瘤,20例药物性肝炎及40例健康人血清中GPC3进行定量检测。同时采用化学发光法检测PHC患者血清中甲胎蛋白水平,并对治疗前后PHC患者血清中GPC3及甲胎蛋白水平进行比较分析。结果 PHC组血清GPC3水平显著高于其他肝病组及健康对照组,差异有统计学意义(P0.05)。转移性肝癌、肝硬化及病毒性肝炎组血清GPC3水平显著高于其他良性肝病组和健康对照组,差异有统计学意义(P0.05)。PHC组血清GPC3水平与甲胎蛋白水平及肝功能状况无关。GPC3与甲胎蛋白诊断PHC的阳性率分别为65%和56.7%,两者联合检测可将PHC的诊断率提高至85%。在23例治疗有效的PHC患者中,15例患者血清中GPC3水平较治疗前呈现稳定的下降趋势,而仅有10例患者血清中甲胎蛋白呈现与疗效相似的下降趋势。结论 GPC3与甲胎蛋白联合检测有望提高PHC的早期诊断率,同时血清GPC3的不同阈值或可在PHC及其他各类肝脏疾病的鉴别诊断过程中发挥作用。GPC3具有较甲胎蛋白更优的特异性及灵敏度,或可成为判断PHC治疗疗效的一种特异性血清学标志。
[Abstract]:Objective to investigate the clinical significance of detection of phosphatidylinositol proteoglycan (PPC 3) in serum for the diagnosis of primary hepatocellular carcinoma (HCC) and the evaluation of its curative effect. GPC3 in serum of 60 patients with PHC, 60 patients with metastatic liver cancer and 50 patients with liver cirrhosis and 50 patients with chronic viral hepatitis and 20 patients with hepatic cyst and 20 patients with hepatic hemangioma and 20 patients with hepatic hemangioma and 40 healthy persons were quantitatively detected by chemical method. The levels of alpha-fetoprotein in serum of patients with PHC were detected by luminescence method. The serum levels of GPC3 and alpha-fetoprotein in patients with PHC were compared before and after treatment. Results the levels of serum GPC3 in PHC group were significantly higher than those in other liver diseases group and healthy control group, and the difference was statistically significant (P 0.05). The serum GPC3 levels in patients with liver cirrhosis and viral hepatitis were significantly higher than those in other benign liver diseases and healthy controls. There were significant differences in serum GPC3 level and AFP level and liver function. The positive rates of PHC diagnosed by GPC3 and AFP were 65% and 56.7, respectively. The diagnostic rate of PHC could be increased to 85% by combined detection. 23 cases were treated with AFP. The serum GPC3 level in 15 patients with effective PHC showed a steady downward trend compared with that before treatment. Only 10 patients showed a similar decreasing trend in serum AFP. Conclusion the combined detection of GPC3 and AFP may improve the early diagnosis rate of PHC. At the same time, the different thresholds of serum GPC3 may play a role in the differential diagnosis of PHC and other kinds of liver diseases. GPC3 has better specificity and sensitivity than alpha-fetoprotein, and may be a specific serological marker to judge the therapeutic effect of PHC.
【作者单位】：南方医科大学南方医院肿瘤内科;南方医科大学南方医院消化内科;南方医科大学珠江医院肝胆外科;
【基金】：国家消化系统疾病临床医学研究中心科技支撑项目(2015BAI13B07) 广州市科技计划项目(2014Y2-00088)
【分类号】：R735.7

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