标题：高尔基体蛋白-73和骨桥蛋白在肝癌肝硬化中的表达及对肝硬化分级辅助诊断的价值

      作者：赵艳 1，王宏鑫 2，郭丽娜 3，闫海洋 2，胡金朋 2，王振国 2    1.天津市和平区南营门街社区卫生服务中心，天津 300041；2.武警特色医学中心急诊科，天津 300162；3.天津医科大学第二医院肝胆胰外科，天津 300211

      卷次： 2021年32卷19期

      【摘要】 目的 探索高尔基体蛋白-73 (GP73)和骨桥蛋白(OPN)在肝癌肝硬化中的表达及对肝硬化分级辅助诊断的价值。方法 选择2017年5月至2020年5月武警特色医学中心接收的72例肝癌肝硬化患者作为肝硬化组，选择同期 40 例健康体格检查者作为对照组，比较两组受检者的肝硬化相关指标和血清GP73、OPN水平，分析GP73、OPN与肝癌肝硬化相关指标、Child-Pugh分级以及肿瘤大小的关系，最后通过受试者工作特征曲线(ROC)分析GP73、OPN对肝癌肝硬化诊断的价值。结果 与对照组比较，肝硬化组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原时间(PT)、总胆红素(TBIL)、甲胎蛋白(AFP)、OPN、GP73水平明显升高，血红蛋白(Hb)、白细胞(WBC)、血小板(PLT)、血浆白蛋白(ALB)水平明显下降，差异均具有统计学意义(P<0.05)；GP73、OPN与AFP、TBIL、PT、Child-Pugh分级均呈正相关(P<0.05)，与ALB均呈负相关(P<0.05)；与肝癌直径＜3 cm组比较，肝癌直径≥3 cm组患者的GP73和OPN表达水平明显升高，差异均具有统计学意义(P<0.05)；AFP、OPN和GP73诊断肝癌肝硬化的灵敏度为 73.6%、77.3%、79.2%，特异性为 85.0%、87.5%、85.0%，而OPN、GP73与AFP联合诊断对肝癌肝硬化具有更高的灵敏度和特异性，分别为97.3%、71.5%。结论 GP73、OPN均与肝癌肝硬化指标及Child-Pugh分级相关，与AFP联合能够提高肝癌肝硬化检出率，可以作为肝癌肝硬化的辅助诊断指标。
      【关键词】 肝癌肝硬化；高尔基体蛋白-73；骨桥蛋白；甲胎蛋白；Child-Pugh 分级
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2021）19—2462—04

Expression of Golgi protein-73 and osteopontin in hepatocarcinoma cirrhosis and their value in auxiliarydiagnosis of liver cirrhosis grading.
ZHAO Yan 1, WANG Hong-xin 2, GUO Li-na 3, YAN Hai-yang 2, HU Jin-peng 2,WANG Zhen-guo 2. 1.Tianjin Heping District Nanyingmen Street Community Health Service Center, Tianjin 300041, CHINA;2. Emergency Department, Special Medical Center of the Armed Police Force, Tianjin 300162, CHINA; 3. Department ofHepatobiliary and Pancreatic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, CHINA
【Abstract】 Objective To explore the expression of Golgi protein-73 (GP73) and osteopontin (OPN) in livercancer and liver cirrhosis and their value in the diagnosis of liver cirrhosis. Methods Seventy-two patients with livercancer and liver cirrhosis accepted by the Special Medical Center of the Armed Police Force from May 2017 to May2020 were selected as the experimental group, and 40 healthy physical examination subjects during the same period wereselected as the control group. The liver cirrhosis-related indicators, serum GP73, and OPN levels were compared be-tween the two groups, and the relationship between GP73, OPN and liver cancer, liver cirrhosis-related indicators,Child-Pugh classification, as well as tumor size was analyzed. Rceiver operating characteristic (ROC) curve was used toanalyze the value of GP73 and OPN in the diagnosis of liver cancer. Results Compared with the control group, the lev-els of alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), total bilirubin (TBIL),alpha-fetoprotein (AFP), OPN, and GP73 significantly increased in the experimental group, and the levels of hemoglobin(Hb), white blood cells (WBC), platelets (PLT), and plasma albumin (ALB) were significantly decreased, with statistical-ly significant differences (P<0.05). GP73, OPN were positively correlated with AFP, TBIL, PT, Child-Pugh grades (P<0.05), and negatively correlated with ALB (P<0.05). Compared with the liver cancer diameter<3 cm group, the expres-sion levels of GP73 and OPN in the liver cancer diameter≥3 cm group were significantly higher (P<0.05). The sensitivi-ty of AFP, OPN, and GP73 in diagnosing liver cancer and liver cirrhosis was 73.6%, 77.3%, 79.2%, and the specificitywas 85.0%, 87.5%, 85.0%, while OPN, GP73 combined with AFP has higher sensitivity and specificity for liver cancerand liver cirrhosis (97.3% and 71.5%). Conclusion GP73 and OPN are both related to liver cancer and liver cirrho-sis-related indicators and Child-Pugh classification. The combination with AFP can increase the detection rate of livercancer and liver cirrhosis, and can be used as an auxiliary diagnostic indicator for liver cancer and liver cirrhosis.
      【Key words】 Liver cancer and liver cirrhosis; Golgi protein-73 (GP73); Osteopontin (OPN); Alpha-fetoprotein(AFP); Child-Pugh classification