关键词: 原发性肝癌, 高尔基蛋白体73（GP73）, 甲胎蛋白异质体3（AFP-L3）, α-L-岩藻糖苷酶, 诊断

Abstract: Objective To investigate the clinical implications of serum Golgi protein 73（GP73）,lentil lectin-reactive alpha-fetoprotein-L3（AFP-L3）,AFP,and α-L- fucosidase（AFU） in patients with primary liver cancer（PLC）. Methods 261 patients with PLC,201 patients with hepatitis B liver cirrhosis （LC）,238 patients with chronic hepatitis B（CHB） and 200 healthy individuals were recruited in this study betweem January 2015 and March 2017,and serum levels of GP73,AFP-L3,AFP and AFU were detected. The efficacy of diagnosis was performed by Logistic fitting and the ROC curve were drawn to calculate their diagnostic efficacy. Results Serum GP73 level in patients with PLC was significantly lower than in patients with CHB or in patients with LC（P<0.05）,serum AFP-L3 level was much higher than those in patients with CHB,with LC or healthy persons（P<0.05）,and serum AFU level was much higher than in healthy persons or in patients with LC,but much lower than in patients with CHB（P<0.05）;the AUC of serum GP73,AFP-L3,AFP and AFU in diagnosing PLC based on comparison with non-PLC individuals were 0.564（95%CI：0.485-0.636）,0.724（95%CI：0.555-0.786）,0.745（95%CI：0.654-0.806） and 0.571（95%CI：0.385-0.536）,and the cut-off-value of serum AFP-L3 and serum AFP combination were 8.25% and 49.25 ng/mL,with the sensitivity（Se） of 55.5%,specificity（Sp） of 85.0% and accurracy （Ac） of 80.1%,significantly higher than 55.5%,85.0% and 76.4% by serum AFP-L3 or 57.1%,82.7% and 75.2% （P<0.05） by serum AFP alone;out of 261 patients with PLC,71 patients （27.2%） had serum AFP<9.6 ng/ml,and 30（42.3%） of them had serum PG73>106.5 ng/ml,suggesting the latter might be useful in diagnosing PLC patients with lower or negative serum AFP;out of 201 patients with LC,serum AFP levels were less than 9.6 ng/ml in 98（48.8%）,and 53.1% of them（52/98） had serum PG73 level being greater than 106.5 ng/ml,hinting that liver cirrhosis might impact serum GP73 level. Conclusion Serum GP73 level is associated with liver injury and fibrosis and serum AFU level is of little significance for the diagnosis of patients with PLC. The application serum AFP combined with AFP-L3 might improve the efficacy in diagnosing patients with PLC,while the Se and Sp are still not high. The clinicians should take this into consideration and make a relatively accurate diagnosis by detailed illness history,comprehensive physical examination and necessary imaging.

Key words: Hepatoma, Golgi protein 73, Lentil lectin-reactive alpha-fetoprotein-L3, α-L- fucosidase, Diagnosis