| Background/AimsChina has the biggest population of chronic hepatitis B patients in the world, and chronic hepatitis B virus infection is closely related to primary hepatic carcinoma. Alpha-fetoprotein (AFP) is currently the most widely used serum marker of liver cancer. However, the limited sensitivity and specificity can not meet the clinical need. In recent years, a variety of new serum markers of liver cancer have been found, and Golgi protein 73 (GP73) and alpha-fetoprotein variant (AFP-L3) are the most promising biomarkers.The aims of this study are to explore the signifcance of Golgi protein 73(GP73) and Alpha-fetoprotein variant(AFP-L3) in the diagnosis for primary hepatic carcinoma related with hepatitis B virus.MethodsWe collected blood serum of 132 cases, including 56 cases of primary hepatic carcinoma,33 cases of liver cirrhosis,23 cases of chronic hepatitis B patients,20 cases of healthy controls, from June 2009 to August 2010 out-patient clinics and hospitalized patients, in Jinan Infectious Disease Hospital. Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum level of GP73 in 56 cases of PHC,33 cases of liver cirrhosis,23 cases of chronic hepatitis B and 20 healthy individuals. AFP-L3 was isolated by using affnity microcentrifugalcolumn; AFP and AFP-L3 were detected with chemiluminescent immunoassay and then the proportion of AFP-L3 were calculated. SPSS 16.0 software was applied to analyze GP73 and AFP-L3% difference in the expression of each group, and draw the receiver operating characteristic curve to determine the optimal cut-off value of GP73 and AFP-L3% in diagnosing PHC and the sensitivity and specificity when combination of the two biomarkers.Results1. The serum GP73 level in PHC, liver cirrhosis, chronic hepatitis and healthy groups were 247.05 (228.35～287.72) ng/mL,176.83 (159.51～183.98) ng/mL,152.58 (135.19～162.85) ng/mL,43.00 (37.96～52.64) ng/mL respectively, and AFP-L3% were 14.52 (12.33～15.28)%,5.68 (4.32～7.74)%> 4.31 (3.57～6.45)%,3.29 (2.60～4.25)%respectively.2. The differences of GP73 and AFP-L3% levels in PHC group and other groups were statistically significant (P all<0.01).3. Differences between hepatitis, liver cirrhosis groups and healthy control group GP73 levels were statistically significant (P all 0.01); The hepatitis group and the cirrhosis group have no significant difference in GP73 levels (P> 0.05).4. The difference of AFP-L3% levels in cirrhosis group and healthy control group was statistically significant (P<0.05); however, differences of AFP-L3% levels between cirrhosis and hepatitis, hepatitis group and the healthy control group have no statistical significance (P all> 0.05).5. The area under the ROC curve of GP73 and AFP-L3% were 0.825,0.828 respectively, and the optimal cut-off values were 187.60ng/mL,9.98% when diagnosing PHC, with sensitivities of 69.6%,64.3% and specificities of 86.8%,96.1% respectively.6. Joint detection of GP73 and AFP-L3% could improve the sensitivity up to 82.1% and maintain a high specificity of 85.5%. Conclusions1. The levels of GP73 and AFP-L3%in the serum of PHC is higher than that of healthy people and chronic liver diseases.2. GP73 levels in chronic hepatitis, liver cirrhosis are higher than healthy people; GP73 between hepatitis and cirrhosis patients has no significant difference.3. AFP-L3% in patients with cirrhosis was higher than healthy; the level of AFP-L3% between patients with cirrhosis and chronic hepatitis has no significant difference; the level of AFP-L3% between chronic hepatitis and healthy has no significant difference.4. Both serum GP73 and AFP-L3% could be used as biomarker in diagnosing PHC, and joint detection could improve diagnostic performence. |
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