目的 探讨联合检测高尔基体糖蛋白73（GP-73）与甲胎蛋白异质体百分比（AFP-L3%）和总胆汁酸(TBA)在原发性肝癌诊断中的临床应用。 方法 收集2013年5月至2013年12月期间，在我院确诊的肝癌患者100例（PHC组），肝硬化患者50例（肝硬化组）和正常对照者50例（对照组）。用酶联免疫法分别检测GP-73、AFP-L3的浓度；用放射免疫法检测AFP的浓度，并计算出AFP-L3%；用循环酶法检测TBA水平，然后分别按照检测项目统计分析。各组阳性率比较采用χ2检验， P<0.05为差异有统计学意义。 结果 原发性肝癌组GP-73、AFP-L3%、TBA明显高于肝硬化组和正常对照组，差异有统计学意义（P <0.05）；三项联合检测的阳性率为95.0%，明显高于单项分别测定GP-73、AFP-L3%、TBA的阳性率,差异有统计学意义（P <0.05）；GP-73、AFP-L3%、TBA的阳性率明显高于AFP的阳性率，差异有统计学意义（P <0.05）。结论 血清GP-73、AFP-L3%和TBA联合检测明显提高原发性肝癌的阳性率，对原发性肝癌的早期诊断有重要的临床意义。

Objective To evaluate the clinical application of combined detection of golgi glycoprotein 73（GP-73），percentage of AFP heterogeneity（AFP-L3 %）and total bile acid（TBA）in diagnosis of primary hepatocellular carcinoma. Methods 100 cases of primary hepatocellular carcinoma patients（primary hepatocellular group）, 50 cases of patients with cirrhosis（cirrhosis group） and 50 normal controls（control group）were involved in this study. The concentration of GP-73 and AFP-L3 were measured by enzyme-linked immunosorbent assay and the level of alpha-fetoprotein（AFP）was detected by radioimmunoassay and the level of TBA was measured by enzymatic cycle. Results The level of GP-73，AFP-L3% and TBA in primary hepatocellular carcinoma group were significantly higher than that in the cirrhotic group and control group（P <0.05）. The positive rate of three tumor markers combined determination was 95.0%，which was significantly higher than that of individual determination of GP-73、AFP-L3 and TBA（P <0.05）. The positive rate of individual determination of GP-73, AFP and TBA was obviously higher than that of AFP（P <0.05）. Conclusion The combined detection of serum GP-73, AFP-L3% and TBA could improve the positive rate of primary hepatocellular carcinoma and has important clinical significance in early diagnosis of primary hepatocellular carcinoma.