血浆硫氧还蛋白对肝癌的诊断价值研究  

The Value of Plasma Thioredoxin in the Diagnosis of Hepatocellular Carcinoma

作　　者：刘保魁[1] 杨玉秀[2] 韩双印[2] 张立达[2] 白阳秋[2] 房新辉[2] 

机构地区：[1]郑州大学第一附属医院消化内科,河南省郑州市450003 [2]河南省人民医院消化内科

出　　处：《中国全科医学》2013年第14期1578-1580,共3页Chinese General Practice

摘　　要：目的通过检测肝癌患者血浆硫氧还蛋白(TRX)和甲胎蛋白(AFP)水平,探讨TRX对肝癌的诊断价值。方法 2012年5—9月,应用酶联免疫吸附技术(ELISA)检测90例肝癌患者(肝癌组)、40例肝硬化患者(肝硬化组)和35例健康体检者(对照组)血浆TRX和AFP水平,通过受试者工作特征(ROC)曲线计算TRX诊断肝癌的敏感度和特异度,并分析TRX的表达与肝癌患者临床特征之间的关系。结果肝癌组血浆TRX水平明显高于肝硬化组和对照组,差异有统计学意义(P<0.05),TRX水平和AFP水平间无直线相关性(r=-0.06,P=0.560)。不同年龄、性别、肝炎病毒感染状态、肿瘤大小、肿瘤组织分化程度及TNM分期的肝癌患者血浆中TRX的水平间差异均无统计学意义(P>0.05)。ROC曲线分析显示以33.0μg/L为临界值,TRX诊断肝癌的敏感度为74.4%,特异度为77.3%。90例肝癌患者血浆TRX阳性50例,阳性率55.6%,AFP阳性30例,阳性率33.3%;TRX联合AFP检测阳性例数65例,阳性率72.3%。结论血浆TRX可成为诊断肝癌的新的辅助肿瘤标志物,TRX和AFP联合检测可以提高肝癌的早期诊断率。Objective To investigate the diagnostic value of plasma thioredoxin （TRX） in the diagnosis of hepatocel- lular carcinoma （HCC）. Methods From May- September 2012, enzyme linked immunosorbent assay （ELISA） was used to determine the plasma levels of TRX and AFP in 90 patients with HCC, 40 patients with cirrhosis, and 35 healthy controls. The sensitivity and specificity of TRX in diagnosing HCC were determined through ROC curve and the relationship between the expres- sion of TRX and clinical parameters in HCC patients was analyzed. Results The plasma TRX level in HCC patients was higher than that in cirrhosis patients and healthy controls （P 〈 0. 05 ）. There was no correlation between plasma levels of AFP and TRX in 90 patients with HCC （ r = - 0. 06, P = 0. 560）. The plasma TRX level was not associated with age, gender, hepatitis in- fection status, tumor size and histological differentiation and TNM stage of HCC patients （P 〉 0.05）. The best cut - off value of TRX was 33.0 μg/L, which yielded a sensitivity and specificity of 74.4% and 77.3%, respectively for diagnosis of HCC. TRX positive rate was 55.6% （50/90）, AFP positive rate was 33.3% （30/90） , and the combined TRX and AFP positive rate was 72. 3% （65/90）. Conclusion Plasma TRX might serve as a new complementary tumor marker for HCC. Combined detection with TRX and AFP could improve HCC early diagnosis.

关 键 词：癌 肝细胞 硫氧还蛋白 酶联免疫吸附测定 甲胎蛋白类 

分 类 号：R735.7[医药卫生—肿瘤]