To explore the clinical application values of the detection of golgi protein-73(GP73), alpha-fetoprotein variants(AFP-L3), alpha fetoprotein(AFP) in the diagnosis of elderly hepatocellular carcinoma(HCC).

Forty cases of HCC patients(HCC group), 21 cases with benign tumor of liver (benign tumor of liver group)and 19 cases with cirrhotic patients (liver cirrhosis group) were enrolled.GP73 was detected by double antibody sandwich enzyme linked immunosorbent lenscu-linaris (ELISA), AFP and AFP-L3 were examined with electrochemiluminescence immunoassay (ECLIA), AFP-L3 was isolated with agglutinin-coupled spin cloumn(ACSC).

The differences of AFP, AFP-L3, AFP-L3%, GP73 among groups were statistically significant (F=213.04, 151.98, 231.80, 657.04; P<0.01). The expressions of AFP, AFP-L3, AFP-L3% and GP73 of HCC group [(681.41±195.56)μg/L, (138.11±44.00)μg/L, (15.31±3.28)%, (158.18±14.78)μg/L] were higher than those of benign tumor liver group [(7.94±3.50)μg/L, (0.41±0.28)μg/L, (3.58±0.51) %, (49.26±8.76) μg/L], the differences were statistically significant(q=22.41, 22.21, 25.18, 47.34; P<0.01). The expressions of AFP, AFP-L3, AFP-L3% and GP73 of liver cirrhosis group were more obvious [(64.19±33.59) μg/L, (3.94±2.91) μg/L, (4.23±0.71) %, (46.88±11.64) μg/L], compared with HCC group, the differences were statistically significant (q=25.18, 23.56, 27.72, 47.63; P<0.01). However, there were no significant differences of expression between benign tumor of liver group and liver cirrhosis group (q=1.79, 0.513, 1.46, 1.11; P>0.05). The areas of AFP, AFP-L3, AFP-L3% and GP73 under the receiver operating characteristic (ROC) curves in the differential diagnosis of primary hepatic carcinoma (PHC) were 0.744, 0.799, 0.720, 0.875, and the area of GP73 was the largest. The sensitivity and specificity of AFP were 62.5% and 80.0%, AFP-L3 were 70.0% and 77.5%, GP73 were 90.0% and 70.0%.Compared with the single detection, the sensitivity and specificity of AFP and AFP-L3 parallel testing were 86.7% and 95.5%, AFP and GP73 parallel testing were 96.3% and 95.5%, AFP-L3 and GP73 parallel testing were 97.0% and 93.3%.

GP73 and AFP-L3 are expected to become new serum markers for diagnosis of primary liver cancer.The allied combination of serum GP73, AFP-L3 and AFP makes up for the insufficient clinical applications of individual serum makers.