HC-gp39 和GP73 检测对原发性肝癌的诊断 及TACE 预后的评估价值

Value of HC-gp39 and GP73 in the diagnosis of primary liver cancer and prognosis of TACE

摘要:

目的 探讨血清人软骨糖蛋白39（HC-gp39）和高尔基体糖蛋白73（GP73）检测对原发性肝癌 （PHC）的诊断及经导管肝动脉化疗栓塞术（TACE）预后的评估价值。方法 选取2016 年6 月—2018 年 6 月丽水市人民医院收治的PHC 患者58 例作为观察组，同期该院健康体检者60 例作为对照组。检测两组 血清HC-gp39、GP73 水平，采用受试者工作特征（ROC）曲线和生存曲线分析HC-gp39、GP73 在PHC 患者TACE 预后中的评估价值。结果 观察组治疗前、治疗后1 个月血清HC-gp39、GP73 水平均高于对 照组（P <0.05），且观察组治疗后1 个月低于治疗前（P <0.05）。血清HC-gp39、GP73 联合诊断PHC 的 ROC 曲线下面积（AUC）为0.814（95% CI ：0.733，0.892），敏感性和特异性分别为70.0%（95% CI ：0.636， 0.766）和88.6%（95% CI ：0.822，0.969）。治疗后血清HC-gp39<335.76 pg/ml 患者总体生存率（33.33%）高 于血清HC-gp39 ≥ 335.76 pg/ml 患者（25.00%）（P <0.05）；治疗后血清HC-gp39<335.76 pg/ml 患者中 位生存时间（25.50 个月）高于血清HC-gp39 ≥ 335.76 pg/ml 患者（20.86 个月）（P <0.05）。治疗后血清 GP73<213.84 ng/ml 患者总体生存率（38.71%）高于血清GP73 ≥ 213.84 ng/ml 患者（25.00%）（P <0.05）；治 疗后血清GP73<213.84 ng/ml 患者中位生存时间（24.63 个月）高于血清GP73 ≥ 213.84 ng/ml 患者（20.12 个月） （P <0.05）。结论 血清HC-gp39、GP73 水平升高对PHC 具有一定诊断价值，联合诊断价值更高。TACE 术 后血清HC-gp39、GP73 水平降低PHC 患者的生存质量明显优于未降低患者，两者对TACE 术后预后具有 一定评估价值。

Abstract:

Objective To investigate the value of serum human cartilage glycoprotein 39 (HC-gp39) and Golgi protein 73 (GP73) in diagnosis of primary liver cancer and prognosis of transcatheter arterial chemoembolization (TACE). Methods Total of 58 patients with primary liver cancer admitted to our hospital from June 2016 to June 2018 were selected as the observation group, and 60 healthy patients during the same period were selected as the control group. The levels of serum HC-gp39 and GP73 in the two groups were detected. The receiver operating characteristic curve (ROC) and the survival curve were used to analyze the diagnostic value of HC-gp39 and GP73 in primary liver cancer and the prognosis of TACE. Results The levels of serum HC-gp39 and GP73 in the observation group were higher than those in the control group before treatment (P < 0.05). 1 month after treatment, the levels of serum HC-gp39 and GP73 in the observation group were lower than those before treatment and higher than those in the control group (P < 0.05). The AUC of serum HC-gp39 and GP73 combined in the diagnosis of primary liver cancer was 0.814 (95% CI: 0.733, 0.892), and the sensitivity and specificity were 70.05% (95% CI: 63.65%, 76.55%) and 88.64% (95% CI: 82.24%, 96.94%) respectively. The overall survival of patients with serum HC-gp39 < 335.76 pg/ml after treatment was 33.33%, higher than 25.00% of patients with serum HC-gp39≥335.76 pg/ml after treatment (χ2= 3.192, P = 0.036). The median survival time of patients with serum HC-gp39 < 335.76 pg/ml after treatment was 25.50 months, higher than 20.86 months of patients with serum HC-gp39≥335.76 pg/ml after treatment (χ2= 5.145, P = 0.020). The overall survival of patients with serum GP73 < 213.84 ng/ml after treatment was 38.71%, which was higher than 25.00% of patients with serum GP73≥213.84 ng/ml after treatment (χ2= 4.176, P = 0.029). The median survival time of patients with serum GP73 < 213.84 ng/ml after treatment was 24.63 months, which was higher than 20.12 months of patients with serum GP73≥213.84 ng/ml after treatment (χ2= 4.996, P = 0.025). Conclusion The levels of serum HC-gp39 and GP73 are elevated in primary liver cancer, and have certain diagnostic value for primary liver cancer, and their combined diagnosis was more valuable. The prognosis of serum HC-gp39 and GP73 with decreasing in patients were significantly better than those of patients without decreasing. HC-gp39 and GP73 have certain value in evaluating the prognosis after TACE.