Objective To compare the levels of Golgi glycoprotein 73 (GP73) , alpha- fetoprotein heterogeneity 3 (AFP- L3) , alpha-fetoprotein (AFP) , and α- L- fucosidase (AFU) between patients with different liver diseases and the diagnostic value of any or a combination of these makers for liver cancer.Methods The 272 patients with liver cancer, 203 patients with liver cirrhosis, and 248 patients with chronic hepatitis admitted to our hospital from January to December, 2013, as well as 210 healthy individuals, were included in the study.Serum levels of GP73, AFP- L3, AFP, and AFU were determined.Comparison of non- normally distributed data was made by Kruskal- Wallis H test, and multiple comparisons were made by Mann- Whitney U test.Comparison of rates was made by chi- square test.P < 0.05 was considered significantly different.Receiver operating characteristic (ROC) curves were drawn with healthy individuals and patients with chronic hepatitis or liver cirrhosis as controls, and Logistic fitting and ROC analysis were used to evaluate the diagnostic values of these markers.Results The GP73 level of liver cirrhosis group (177.0 (116.0, 247.0) ng /ml) was significantly higher than those of liver cancer group (141.0 (83.3, 218.8) ng /ml) and chronic hepatitis group (151.0 (83.0, 235.3) ng /ml) (U = 22 116.5 and 21 052.0, P<0.05 for both) .The AFP- L3 and AFP levels of liver cancer group (11.3 (4.3, 21.2) % and 78.4 (7.1, 2455.8) ng /ml) were significantly higher than those of liver cirrhosis group (6.0 (4.0, 8.0) % and 10.0 (3.8, 49.5) ng /ml) and chronic hepatitis group (7.0 (5.0, 9.0) % and 18.8 (4.4, 79.6) ng /ml) (U = 16009.0 /16083.5 and 22456.5 /22346.5, P < 0.05 for all) .According to the ROC curves drawn using healthy individuals as a control, the areas under the ROC curve (AUCs) for GP73, AFP- L3, AFP, and AFU were 0.827, 0.817, 0.901, and 0.680, respectively;GP73, AFP- L3, and AFP had a higher diagnostic accuracy for liver cancer than AFU.According to the ROC curves drawn using non- liver cancer patients as a control, the AUCs for the four markers were 0.573, 0.734, 0.753, and 0.552, respectively;AFP- L3 and AFP had some diagnostic accuracy for liver cancer, and their cut- off values were 8.55% (56.6%, 84.9%) and 49.88 ng /ml (57.7%, 80.9%) , respectively, when the sensitivity and specificity reached the peak values.Conclusion Increased GP73 is related to hepatic impairment and chronic fibrosis, and it has a better sensitivity for the diagnosis of liver diseases.AFP- L3 and AFP have good specificity for the diagnosis of liver cancer, and a combination of the two markers can increase the diagnostic sensitivity for liver cancer to 62.1%.
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