Clinical Significance And Expression Of GP73 In Serum Of Normal Groups, Hepatitis Groups, Cirrhosis Patients And Primary Hepatocellular Carcinoma

Primary hepatocellular carcinoma (HCC) is the most common malignant tumor in China. In recent years,a variety of new serum tumor markers have emerged one after another. A new serum marker-Golgi glycoprotein-73 (GP-73) in early diagnosis of HCC is expected to become the new target maker,its sensitivity and specificity are better than AFP.Objectives:1. To observe the expression levels of GP-73 in serums of normal people,hepatitis,hepatic cirrhosis groups and patients with HCC,determine its sensitivity and specificity as the biomarker of the diagnosis of liver cancer,the final purpose is to guide the clinical application;2. To observe the correlation of GP-73 and AFP in serums of normal people,hepatitis,hepatic cirrhosis groups and patients with HCC;3. To observe the early diagnostic value of associated detection of GP-73 and AFP in the serums;4. To observe the differential expression of GP-73 in serums of patients with HCC both before and after the operation of TACE.Material and Method:1.The selection of casesRandomly selected the survey of medical and healthy science and technologic projects in Guangzhou (2006-Zda-005)"Guangzhou community population of HCC risk factors and community-based interventions and comprehensive prevention and control researchs"among 25 cases of the normal people,25 cases of the hepatitis groups,25 cases of the hepatic cirrhosis groups. Collecting the Guangzhou Medical College affiliated Tumor Hospital 2009.9-2010.9 of HCC treated 37 cases of newly diagnosed patients(including 22 cases of surgical treatment and 25 cases of TACE)and 10 cases of metastatic liver cancer patients. Take the four groups of patients with fasting blood,HCC group and TACE treatment of surgical patients in the preoperative and postoperative 1 week after getting fasting venous blood.samples separation of serum preserved at -80℃refrigerator.2.The detectionTo use ELISA to detect the GP-73 and AFP levels in the four groups,determining its sensitivity and specificity as the biomarker of the diagnosis of liver cancer.3. Statistical methodsAll this data was used statistical software Spss16.0 computer processing and analysis,normal distribution of measurement data as mean±standard deviation( x±s)that non-normal distribution to the digits mean,setting P<0.05 was statistically significant.Results1. GP73 protein of the area under the ROC curve(AUROC)was 0.887(95% CI:0.794-0.981),sensitivity was 77.8%,specificity was 92%,the best critical point 197ng/ml.The area under the ROC curve of AFP(AUROC)was 0.804(95% CI:0.674-0.934),sensitivity was 74.1%,specificity was 88.0%,the best critical point of 22ng/ml,Combined GP73 with AFP,the sensitivity was 82.6%,specificity was 94%,and the area under the ROC curve was 0.902.2. GP73 protein and AFP in normal people,hepatitis,hepatic cirrhosis groups and patients with HCC were all expressed,and the highest group was primary hepatocellular carcinoma.Gastric cancer,and GP73 protein of the colon cancer and other metastatic liver cancer was slightly higher than healthy people,but it has not statistical significance;3. AFP-negative in 7 cases of HCC patients,5 cases of GP73 are elevated,and 6 cases of the GP73-normal patients,3 cases of AFP are elevated; 4. GP73 protein in the HCC group before surgery and one week after surgery,the difference was statistically significant(P<0.05);GP73 protein in the HCC group before intervention surgery and one week after intervention surgery,the difference was statistically significant(P<0.05)。Conclusions:1. GP73 protein were all expressed in normal people,hepatitis,hepatic cirrhosis groups and patients with HCC,the expression of hepatitis B-related liver cancer is the highest,but the GP73 in gastric cancer,colon cancer and other metastatic liver cancer is not increased.This suggested that serum levels of GP73 protein concentration is closely related to the occurrence and development of HCC;2. By comparing the area under the ROC curve,the sensitivity and specificity of GP73 is superior to AFP in the HCC patients,as a new marker of HCC diagnosis,GP73 protein may take the place of AFP;3. HCC detection of serum concentrations of GP73 protein not only can be used as the diagnostic screening indicator of HCC,it could be used as the indicator of HCC patients with AFP-negative;4. The detection of GP73 protein and AFP of HCC patients can increase the positive detection rate of early stage liver cancer patients,it is very important for the early diagnosis of HCC patients;5. GP73 protein in serum of patients with surgical and interventional treatment levels significantly lower than before treatment.