肝胆相照论坛

标题: 我国学者找到肝癌早诊和评估的新武器 [打印本页]

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作者: tonychant    时间: 2011-10-7 22:26     标题: 我国学者找到肝癌早诊和评估的新武器



北京协和医院肝脏外科通过在国际上率先完成的超过4000例的大样本、多中心、多种族的高尔基体跨膜糖蛋白73(GP73)系列相关研究，证实GP73是肝癌早期诊断和术后复发病情评估的理想血清标记物，敏感性、特异性远高于40年前问世的甲胎蛋白(AFP)，二者联合检测将大幅提升肝癌的诊治水平。肝外科毛一雷教授等的论文发表在国际著名杂志GUT今年第12期上，引起国际广泛关注。南昌市第三医院核医学科余永波。

研究组测定了肝癌高危人群GP73和AFP的敏感度和特异度，结果发现GP73对肝癌的敏感度为74.6%、特异度为97.4%；同组患者AFP对肝癌的敏感度和特异度分别为58.2%和85.3%，提示GP73在肝癌检测的敏感度和特异度上均远高于AFP。而将GP73和AFP联合检测后，敏感度、特异度提高到89.2%和85.2%。研究通过肝癌组与健康组的对照，国际上首先确立了GP73的正常值为1.2(0.9~1.7)相对单位，肝癌组血清 GP73平均值为14.7(8.9~29.4)相对单位，远高于健康对照组，且与肿瘤个体的大小无关。

非常有意思的是，研究组在国际上首次前瞻性地对肝癌患者术前、术后及随访等的连续观察表明，患者GP73水平随着肿瘤切除而下降，术后14天跌到谷底；当肿瘤复发后GP73亦开始反弹，这一发现揭示了GP73在肝癌患者的术后随访和复发监测中的明确意义。

本研究支持了乙肝病毒感染是肝癌的重要致病原因。大样本数据显示乙肝病毒携带者和肝硬化患者的GP73值均有一定程度的升高，但一般均小于5相对单位，明显低于肝癌患者。暗示GP73在监测患者从携带乙肝病毒发展到肝硬化，最终发展为肝癌的整个疾病进程中的重要意义。

研究组还首次检测了与肝硬化/肝癌无关的胃癌、食道癌、结直肠癌、胰腺癌、肾癌、膀胱癌、肺癌、宫颈癌、子宫内膜癌等14种临床常见癌症的GP73值，结果证实GP73在其它良、恶性肿瘤中尽管有轻度升高，但增高值远远低于原发性肝细胞肝癌患者，证实GP73为肝癌的单一肿瘤标记物。此外，协和肝外科还联合医科院基础所成功合成了自己的GP73单克隆抗体，为今后临床推广打下了良好基础。

毛一雷教授指出，GP73的出现要归因于近年来蛋白组学和分子生物学的进步。GP73和AFP联合检测可提高肝癌的早期诊断、早期治疗水平。该研究组正在计划一项更大的、长期的研究，联合应用GP73、AFP和影像学手段对高危人群进行监测、随访，希望能达到早期发现肝癌、改善患者预后的目的，从而减轻我国该方面的经济和社会负担。




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作者: 路一直都在    时间: 2011-10-8 13:02

天朝出来的什么专利 研究成果我是不相信的 他们的爆出来的研究成果实际上都是广告 不能看广告 要看疗效

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作者: wopiaofeng    时间: 2011-10-14 11:06

这些都成为媒体企业吸引人们买他们的股票！融资的重要手段！
政府浮躁 媒体浮躁 人民浮躁！

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作者: springa    时间: 2011-10-16 08:35

无实用价值.
不信,你看哪家医院会用它?
另外,302已经将GP73用于临床了?有何价值?
302医院肝癌临床检测 显示GP73试剂有效





由解放军第302医院研制的新型“肝癌标志物高尔基体蛋白GP73定量测定试剂”，日前获准运用于临床肝癌检测。该试剂可准确定量测定人血液中肝癌标志物GP73的含量，将为肝病患者提前预警肝癌发生提供可靠的依据。


研究发现，肝病患者血液中高尔基体蛋白GP73含量异常与肝肿瘤的发生密切相关。尤其是在早期肝癌的诊断中，GP73比常用的传统检测指标甲胎蛋白出现得更早，更易于诊断，因此其被认为是早期诊断肝癌的血清标志物。解放军第302医院临床检验医学中心经过研究和试验，筛选出高特异、高灵敏的高尔基体蛋白GP73的单抗，制备出高尔基体蛋白GP73定量测定试剂。

目前，该试剂已经过国内6家医院参加的多中心临床研究后证实，能有效区分肝癌与其他良性肝病。该试剂和现有的甲胎蛋白联合使用，可将肝癌阳性检出率提高至88%。(科技日报)

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作者: StephenW    时间: 2011-10-16 09:54

在美国研究也进行了 (2005).


GP73, a resident Golgi glycoprotein, is a novel serum marker for hepatocellular carcinoma

• Jorge A. Marrero
  ,
• Patrick R. Romano
  ,
• Olga Nikolaeva
  ,
• Laura Steel
  ,
• Anand Mehta
  ,
• Claus J. Fimmel
  ,
• Mary Ann Comunale
  ,
• Anthony D'Amelio
  ,
• Anna S. Lok
  ,
• Timothy M. Block
  

Received 8 March 2005; received in revised form 19 April 2005; accepted 8 May 2005.  published online 28 June 2005.

Background/AimsGolgi protein-73 (GP73) is up-regulated in hepatocellular carcinoma (HCC). The aims of this study were to determine if GP73 is detected in the serum, and to establish the sensitivity and specificity of serum GP73 for diagnosing HCC.
MethodsSerum GP73 was detected by immunoblots and quantified by densitometric analysis.
ResultsA total of 352 patients were studied. Serum GP73 levels were significantly higher in patients with HCC compared to those with cirrhosis (P<0.001). GP73 had a sensitivity of 69% and a specificity of 75% at the optimal cutoff point of 10 relative units, with an area under the receiver operating curve of 0.79 vs. 0.61 for AFP (P=0.001). GP73 levels had significantly higher sensitivity (62%) than AFP (25%) for diagnosing early HCC (P<0.0001). Moreover, GP73 levels were elevated in the serum of 57% (32/56) of individuals with HCC who had serum AFP levels less than 20ng/ml.
ConclusionsHigher levels of GP73 can be found in the serum of patients with HCC than of those without. GP73 was better than AFP for the diagnosis of early HCC. Further validation studies are needed to confirm the role of GP73 in the early detection of HCC.

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作者: StephenW    时间: 2011-10-16 09:57



回复 tonychant 的帖子

这是一个关于发表的研究评论.

Gut Online First, published on September 28, 2010 as 10.1136/gut.2010.214916
Significance of this study
What is already known?
< AFP has been the only standard serum marker
for the detection of HCC for the last 40 years,
even though its sensitivity of 39e65% is
unsatisfactory.
< Golgi protein 73 (GP73) is a potential serum
marker for HCC but has not been validated in
large cohort studies.
< Whether GP73 is a better serum biomarker than
AFP is controversial.
What are the new findings?
< Combined measurement of GP73 and AFP
increased the sensitivity for HCC to 89.2%
(95% CI 86.7% to 91.5%), with a specificity of
85.2% (95% CI 83.4% to 86.4%).
< GP73 decreased following surgical resection of
HCC lesions and increased with tumour
recurrence.
< Non-liver cancers in 14 organs (colon, rectum,
stomach, oesophagus, pancreas, lung, thyroid,
kidney, bladder, prostate, breast, ovary, cervix
and endometrium) were analysed; all the benign
and other malignant liver lesions had moderate
elevations of GP73, albeit at a much lower level
than in HCC.
How might it impact on clinical practice in the
foreseeable future?
< Combined measurement of AFP and GP73
shows promise to improve the detection and
treatment of HCC.
Mao Y, Yang H, Xu H, et al. Gut (2010). doi:10.1136/gut.2010.214916 1 of 7
Paper
Gut Online First, published on September 28, 2010 as 10.1136/gut.2010.214916
Copyright Article
http://www.hepb.org/pdf/Millis.GP73.Gastro,2010.pdf

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