上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (2): 208-.

• 论著（临床研究） • 上一篇    下一篇

外周血GPC3与PEG10 mRNA检测对肝细胞癌转移的诊断价值

张 洁1, 王之青1, 于嘉屏1, 李继强2, 葛海良3   

  1. 1. 上海交通大学 医学院仁济医院检验科, 2. 上海市消化疾病研究所, 上海 200001；3. 上海交通大学 基础医学院免疫学教研室, 上海 200025
  • 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 葛海良, 电子信箱: gehl@shsmu.edu.cn。
  • 作者简介:张 洁 （1965—）, 女, 副主任技师, 学士；电子信箱: jane_zhanlin@hotmail.com。
  • 基金资助:

    上海市科委基金（06ZR14063）

Value of GPC3 and PEG10 mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma

ZHANG Jie1, WANG Zhi-qing1, YU Jia-ping1, LI Ji-qiang2, GE Hai-liang3   

  1. 1. Clinical Laboratory, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 2. Shanghai Institute of Digestive Disease, |Shanghai 200001, China；3. Department of Immunology, Basic Medical College, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2010-02-25 Published:2010-02-25
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 06ZR14063

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摘要：

目的 研究外周血磷脂酰肌醇蛋白聚糖3（GPC-3）与遗传印迹基因（PEG10）mRNA检测对肝细胞癌（HCC）转移的诊断价值。方法 30例HCC患者分为HCC转移组（n=18）和HCC未转移组（n=12），另选取11例肝硬化患者作为对照。以SYBR Green I 作为荧光信号，采用实时荧光定量聚合酶链反应（FQ RT-PCR）检测三组患者外周血GPC-3 mRNA 和PEG10 mRNA表达，应用ROC曲线和诊断性能专用指标评价两者预测诊断及排除诊断的价值。结果 HCC转移组GPC-3 mRNA和PEG10 mRNA表达显著高于HCC未转移组和肝硬化组（P＜0.05）；HCC未转移组与肝硬化组GPC-3 mRNA和PEG10 mRNA的表达比较差异无统计学意义。单项检测GPC-3 mRNA和PEG10 mRNA的诊断灵敏度分别为66.7%和72.2%，特异度均为91.7%，ROC曲线下面积(AUC)为 0.748和0.812；两基因检测平行试验的灵敏度为90.7%，特异度为84.0%，阴性似然比为0.11，诊断准确率为83.3%；系列试验的灵敏度为60.5%，特异度为98.7%，阳性似然比为45.5，诊断准确率为73.3%。结论 检测外周血GPC-3 mRNA和PEG10 mRNA对估计肝癌有无血行播散和肝外转移有一定的价值，且PEG10 mRNA优于GPC-3 mRNA。两者联合系列试验有助于HCC外周血转移的预测诊断。

关键词: 肝细胞癌, 转移, 磷脂酰肌醇蛋白聚糖3基因, 遗传印迹基因, ROC曲线, 联合检测

Abstract:

Objective To explore the value of glypican-3 (GPC-3) mRNA and paternally expressed 10 (PEG10) mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma (HCC). Methods With SYBR Green I as fluorescence signal, real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis (n=8), HCC without metastasis (n=12) and hepatic cirrhosis (n=11), and receiver operator characteristics curve (ROC) and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis (P<0.05), while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis. In single test, the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7% for GPC-3 mRNA and 72.2% for PEG10 mRNA, and the specificities were 91.7% and 91.7%, respectively. The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA. With two markers in parallel test, the sensitivity, specificity, negative likelihood and diagnostic accuracy were 90.7%, 84.0%, 0.11 and 83.3%, respectively. In serial test, the sensitivity, specificity, positive likelihood and diagnostic accuracy were 60.5%, 98.7%, 45.5 and 73.3%, respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC, and PEG10 mRNA works better than GPC-3 mRNA. The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.

Key words: hepatocellular carcinoma, metastasis, glypican-3 gene, paternally expressed gene 10, ROC curve, combined test