GP73的联合检测用于早期肝癌筛查的可行性研究

Feasibility Study on Primary Hepatocellular Carcinoma Screening by GP73 Joint Detection

关键词:  原发性肝癌  高尔基体蛋白73  甲胎蛋白(AFP)  基因

Key words:  primary hepatic carcinoma  Golgi protein 73  alpha-fetoprotein(AFP)  gene

摘要:

目的 探讨高尔基体蛋白73(GP73)血清及其基因表达在原发性肝癌(primary hepatocellular carcinoma，PHC)中的诊断价值。方法 采用酶联免疫吸附试验(ELISA)检测105例PHC、106例肝硬化患者和102例健康人的血清GP73和甲胎球蛋白(alpha-fetoprotein，AFP)水平。采用实时荧光定量(RT-PCR)法对各组外周血单个核细胞GP73 mRNA的拷贝数进行检测，采用Ct值比较法计算GP73 mRNA相对表达水平，并检测12份正常肝组织以及12份肝癌组织的GP73 mRNA相对表达水平。结果 PHC组GP73中位血清浓度明显高于肝硬化组，差异有显著统计学意义(P<0.05)。PHC组和肝硬化组患者的AFP中位血清浓度差异无统计学意义。GP73诊断肝癌的敏感度为72.7%，特异度为70.8%，AFP的敏感度为49.8%，特异度为95.9%。两者联合检测肝癌的敏感度为79.6%，特异度为80.3%。3组间全血GP73 mRNA含量无统计学差异，肝癌组织GP73 mRNA表达量(12.87)明显高于正常肝组织(1.08)，差异有统计学意义(P<0.01)。结论 GP73诊断PHC具有较好的敏感度，GP73与AFP联合检测可进一步提高诊断早期肝癌的敏感度。肝组织标本GP73 mRNA可为诊断原发性肝癌的肿瘤标志，但存在创伤大、风险大等弊端。

Abstract:

OBJECTIVE To investigate the diagnostic value of GP73 in gene detection in the patients of primary hepatocellular carcinoma(PHC). METHODS Enzyme-linked immunosorbent assay(ELISA) was performed to detect the serum level of GP73 and alpha-fetoprotein(AFP) in 105 cases of PHC, 106 cases of hepatic cirrhosis and 102 healthy people. Real-time quantitative (RT-PCR) was used to detect the relative expression of GP73 mRNA in mononuclear cells in peripheral blood of each group. Comparative Ct method was used to estimate the relative expression levels. The liver tissues of normal and PHC were detected at the same time. RESULTS The serum concentrations of GP73 in PHC group were significantly higher than that of cirrhosis patients(P<0.05). The serum AFP concentration in PHC group and cirrhosis group had not statistical difference. Sensitity and specificity of GP73 was 72.7% and 70.8%, respectively. The sensitivity of AFP was 49.8%, the specificity was 95.5%.The sensitivity of GP73 and AFP joint detection was 79.6%, specificity was 80.3%. The GP73 mRNA in whole blood had no significant difference among the three groups, GP73 mRNA expression of hepatocellular carcinoma tissues(12.87) was significant higher than normal liver tissue(1.08)(P<0.01). CONCLUSION GP73 protein has very good diagnostic sensitivity. The joint detection of GP73 and AFP can further improve the early diagnosis performance of liver cancer. The detection of GP73 mRNA in liver tissue samples woule be a good tumor markers for diagnosis of primary liver cancer. But the possibility for trauma and complications is definitely there.