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中国癌症防治杂志

中国癌症防治杂志 ›› 2022, Vol. 14 ›› Issue (1): 38-44.doi: 10.3969/j.issn.1674-5671.2022.01.07

• 基础研究 • 上一篇    下一篇

外周血GPC3在肝细胞癌临床诊断中的价值

  

  • 出版日期:2022-02-25 发布日期:2022-03-11
  • 通讯作者: 马磊 E-mail：malei19860721@sina.com
  • 基金资助:
    国家自然科学基金资助项目（81871998）

The value of peripheral blood GPC3 in the clinical diagnosis of hepatocellular carcinoma

  • Online:2022-02-25 Published:2022-03-11
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摘要： 目的 探讨血清磷脂酰肌醇蛋白聚糖3（glypican-3，GPC3）蛋白和外周血GPC3 mRNA及其联合检测在肝细胞癌（hepatocellular carcinoma，HCC）中的诊断价值。方法 采用免疫组化法检测1例肝癌组织标本中GPC3的表达情况。检索PubMed、Web of Science、Embase和Cochrane library数据库中关于GPC3诊断HCC的文献，根据纳入和排除标准筛选文献，对纳入文献进行数据提取和质量评价，采用MetaDisc 1.4软件进行Meta分析，计算合并的诊断评估指标，绘制综合受试者工作特征（summary receiver operating characteristic，SROC）曲线评估其诊断效能。结果 免疫组化结果显示肝癌组织中特异性表达GPC3。进一步纳入19篇文献（其中血清GPC3蛋白16篇，外周血GPC3 mRNA 5篇）评价外周血中GPC3分子对HCC的诊断效能，结果显示，单独血清GPC3蛋白诊断HCC的合并敏感度、特异度、SROC曲线下面积分别为0.62（95%CI：0.60~0.64）、0.67（95%CI：0.65~0.69）、0.75；外周血GPC3 mRNA诊断HCC的合并敏感度、特异度、SROC曲线下面积分别为0.76（95%CI：0.70~0.81）、0.87（95%CI：0.84~0.91）、0.92。血清GPC3蛋白联合甲胎蛋白（α-fetoprotein，AFP）诊断HCC的敏感度、特异度分别为0.82（95%CI：0.80~0.85）、0.81（95%CI：0.79~0.84），联合异常凝血酶原（des-γ-carboxy prothrombin，DCP）诊断的敏感度和特异度分别为0.74（95%CI：0.68~0.79）、0.76（95%CI：0.70~0.81）。结论 GPC3分子特异性表达于肝癌组织，相对于血清GPC3蛋白，外周血GPC3 mRNA诊断HCC可能具有更高的效能；单独GPC3蛋白的诊断效能有限，联合AFP或DCP可提高其诊断效能，有助于HCC早期诊断。

关键词: 肝细胞癌, GPC3, 诊断, Meta分析

Abstract: Objective To investigate the diagnostic value of serum glypican-3 (GPC3) protein, peripheral blood GPC3 mRNA and combined detection in hepatocellular carcinoma (HCC). Methods The expression of GPC3 in 1 case of hepatocellular carcinoma tissue was detected by immunohistochemistry method. PubMed, Web of Science, Embase and Cochrane library databases were searched for the literature related to GPC3 diagnosis of HCC. The literature was screened according to inclusion and exclusion criteria. Data extraction and quality evaluation were performed on included literature. Meta analysis was performed using MetaDisc 1.4 software, the pooled diagnostic accuracy index was calculated, and the summary receiver operating characteristic (SROC) curve  was drawn to evaluate its diagnostic efficacy. Results The immunohistochemical results showed that GPC3 was specifically expressed in hepatocellular carcinoma. A total of 19 literatures (including 16 serum GPC3 protein articles and 5 peripheral blood GPC3MRNA articles) were further included to evaluate the diagnostic efficacy of peripheral blood GPC3 molecule for HCC, the results showed that, the pooled sensitivity, specificity and area under SROC curve of serum GPC3 protein alone in the diagnosis of HCC were 0.62 (95%CI: 0.60-0.64), 0.67 (95%CI: 0.65-0.69) and 0.75, respectively. The pooled sensitivity, specificity, area under SROC curve of GPC3 mRNA in peripheral blood were 0.76 (95%CI: 0.70-0.81), 0.87 (95%CI: 0.84-0.91) and 0.92, respectively. The sensitivity and specificity of serum GPC3 protein combined with α-fetoprotein (AFP) in the diagnosis of HCC were 0.82 (95%CI: 0.80-0.85) and 0.81 (95%CI: 0.79-0.84), respectively. Combined des-γ-carboxy prothrombin (DCP) were 0.74 (95%CI: 0.68-0.79) and 0.76(95%CI: 0.70-0.81), respectively. Conclusions GPC3 molecule is specifically expressed in hepatocellular carcinoma tissue. Compared with serum GPC3 protein, peripheral blood GPC3 mRNA may have a higher diagnostic accuracy in the diagnosis of HCC. The diagnostic efficacy of serum GPC3 protein alone is limited, whereas its combination with AFP or DCP detection can improve the diagnostic accuracy and help the early diagnosis of HCC.

Key words: Hepatocellular carcinoma, GPC3, Diagnosis, Meta-analysis

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