目的：探讨血清甲胎蛋白（AFP）和高尔基体糖蛋白73（GP73）联合检测对肝细胞癌（HCC）的诊断价值，为早期诊断和鉴别诊断HCC提供依据。方法收集2012年6月－2013年5月住院患者标本共408例，其中HCC患者142例（HCC组），慢性肝炎患者156例（慢性肝炎组），肝硬化患者110例（肝硬化组）。分别采用电化学发光法和酶联免疫吸附试验（ELISA）双抗体夹心法测定3组患者的血清AFP和GP73的浓度，检测结果组间比较采用方差分析，率的比较采用χ2检验。并使用MedCalc统计学软件计算2项指标联合检测对HCC诊断的敏感度和特异度。结果 HCC组血清AFP和GP73的浓度显著高于肝硬化组和慢性肝炎组，差异具有统计学意义（P＜0．05）；肝硬化组血清AFP和GP73的浓度显著高于慢性肝炎组，其差异亦有统计学意义（P＜0．05）。二者联合检测肝细胞癌的敏感度为95．8％，特异度为98．6％，较单项检测差异具有统计学意义（P＜0．05）。结论血清AFP和GP73联合检测对HCC具有较高的诊断价值和临床意义，可作为HCC早期的诊断和鉴别诊断指标，值得在临床上推广。%Objective To investigate the value of combined detection of serum alpha-fetoprotein (AFP)and Golgi protein-73 (GP73)in the diagnosis of hepatocellular carcinoma (HCC)and to provide a basis for early diagnosis and differential diagnosis of HCC.Methods A total of 408 patients hospitalized in Baoji Central Hospital from June 2012 to May 2013,as well as healthy persons who had normal test re-sults in physical examination,were included in the study,and their specimens were collected.These patients were classified into HCC group (n=142),chronic hepatitis group (n=156),and liver cirrhosis group (n=110).Serum levels of AFP and GP73 in the three groups were measured by electrochemiluminescence immunoassay and double -antibody sandwich enzyme -linked immunosorbent assay,respectively. Comparison of test results between groups was made by analysis of variance,and comparison of rates was made by chi-square test.The sen-sitivity and specificity of the two indicators for the diagnosis of HCC were calculated using MedCalc statistical software.Results The HCC group had significantly higher serum AFP and GP73 levels than the liver cirrhosis group and chronic hepatitis group (P<0.05);the liver cirrhosis group had significantly higher serum AFP and GP73 levels than the chronic hepatitis group (P<0.05).The sensitivity and speci-ficity of the two indicators for the diagnosis of HCC were 95.8% and 98.6%,respectively,showing significant differences compared with those of each indicator alone (P<0.05).Conclusion Combined detection of serum AFP and GP73 has high diagnostic value and clinical significance for HCC,and they can be used as indicators for early diagnosis and differential diagnosis of HCC.
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