肝癌介入治疗前后原癌基因Pokemon、甲胎蛋白异质体、甲胎蛋白、脱γ-羧基凝血酶原联合检测的临床价值  

Clinical value of combined detection of pokemon,AFP-L3,AFP and DCP after transarterial chemoembolization for hepatocellular carcinoma

作　　者：张全乐[1] 邢喜芝[1] 张立英[1] 刘三香[1] 李风艳[2] 

机构地区：[1]河北省沧州中西医结合医院消化内科,河北沧州061000 [2]河北省沧州中西医结合医院放射科,河北沧州061000

出　　处：《安徽医药》2017年第3期468-471,共4页Anhui Medical and Pharmaceutical Journal

基　　金：河北省卫生计生委科技支持项目(ZD20140129)

摘　　要：目的研究原癌基因Pokemon、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、脱γ-羧基凝血酶原(DCP)在原发性肝癌(HCC)病人介入治疗前后表达量变化及其与治疗效果之间的关系。方法纳入30例HCC病人,均行肝动脉化疗栓塞(TACE),酶联免疫吸附试验(ELISA)检测治疗前后血清中Pokemon、AFP、AFP-L3、DCP的表达量,分析四者TACE前后表达量变化与治疗效果之间的关系,并对TACE治疗后复发者与未复发者Pokemon、AFP、AFP-L3、DCP的表达量变化进行探讨。结果(1)TACE治疗有效组Pokemon、AFP、AFP-L3、DCP的表达量分别为(50.09±4.91)μg·L^(-1)、(322.67±64.53)μg·L^(-1)、(10.26±1.08)μg·L^(-1)、(42.66±9.43)AU·L^(-1),低于治疗前Pokemon、AFP、AFP-L3、DCP的表达量(103.10±7.65)μg·L^(-1)、(807.36±113.55)μg·L^(-1)、(27.42±3.00)μg·L^(-1)、(93.39±4.70)AU·L^(-1);t=6.741、7.740、7.534、4.985;P=0.000、0.000、0.000、0.001。治疗无效组Pokemon、AFP、AFP-L3、DCP的表达量分别为(87.71±5.73)μg·L^(-1)、(503.20±132.01)μg·L^(-1)、(20.31±2.66)μg·L^(-1)、(73.11±8.36)AU·L^(-1),与治疗前四者的表达量相比(93.47±1.92)μg·L^(-1)、(610.55±101.69)μg·L^(-1)、(21.18±1.97)μg·L^(-1)、(75.01±7.29)AU·L^(-1),差异无统计学意义(t=1.801、1.280、0.626、0.764;P=0.146、0.270、0.565、0.488)。(2)按治疗后3个月是否复发将有效组分为复发者和未复发者,复发者Pokemon、AFP、AFP-L3、DCP的表达量分别为(114.63±16.28)μg·L^(-1)、(763.50±140.22)μg·L^(-1)、(18.58±2.09)μg·L^(-1)、(87.93±8.57)AU·L^(-1),与TACE治疗后1个月(复发前)Pokemon、AFP、AFP-L3、DCP的表达量[(65.90±8.25)μg·L^(-1)、(400.60±99.11)μg·L^(-1)、(9.17±1.27)μg·L^(-1)、(35.93±4.10)AU·L^(-1)]相比,差异有统计学意义(t=2.598、6.247、5.762、6.122;P=0.029、0.000、0.000、0.000)。结论 TACE治疗有效者Pokemon、AFP、AFP-L3、DCP的表达量明显下降,复发者四种标志物的表达量再次升高,提示四者对监测HCC�Objective To explore the correlation between changes of expression levels of Pokemon,AFP,AFP-L3 or DCP after transarterial chemoembolization for hepatocellular carcinoma(HCC) and treatment effectiveness. Methods In this study,the serum levels of Pokemon,AFP,AFP-L3 or DCP in 30 patients with HCC were examined by enzyme-linked immunosorbent assay before and after transarterial chemoembolization. Then the relation between treatment effectiveness and the changes of serum expression levels of Pokemon,AFP,AFP-L3 or DCP was analysed. And the changes of expression levels of Pokemon,AFP,AFP-L3 or DCP in patients with neoplasm recurrence or non-recurrence after transarterial chemoembolization were assessed. Results The serum expression levels of Pokemon,AFP,AFP-L3 or DCP in therapeutic-response group were(50. 09 ± 4. 91) μg · L^(-1),(322. 67 ± 64. 53) μg·L^(-1),(10. 26 ±1. 08) μg·L^(-1),(42. 66 ± 9. 43) AU·L^(-1),apparently lower than those before therapy(103. 10 ± 7. 65) μg·L^(-1),(807. 36 ± 113. 55)μg·L^(-1),(27. 42 ± 3. 00) μg·L^(-1),(93. 39 ± 4. 70) AU·L^(-1)(t = 6. 741,7. 740,7. 534,4. 985; P = 0. 000,0. 000,0. 000,0. 001).The serum expression levels of Pokemon,AFP,AFP-L3 or DCP in therapeutic-nonresponse group were(87. 71 ± 5. 73) μg · L^(-1),(503. 20 ± 132. 01) μg·L^(-1),(20. 31 ± 2. 66) μg·L^(-1),(73. 11 ± 8. 36) AU·L^(-1),which showed no statistically significant difference from those before therapy(93. 47 ± 1. 92) μg·L^(-1),(610. 55 ± 101. 69) μg·L^(-1),(21. 18 ± 1. 97) μg·L^(-1),(75. 01 ± 7. 29) AU·L^(-1)(t = 1. 801,1. 280,0. 626,0. 764; P = 0. 146,0. 270,0. 565,0. 488). Therapeutic-response group was further assigned into recurrence and non-recurrence groups according to whether there was neoplasm recurrence or not 3 months after treatment. The serum expression levels of Pokemon,AFP,AFP-L3 or DCP in neoplasm recurrence group were(114. 63 ± 16. 28) μg·L^(-1),(763. 50 ± 140. 22) μg·L^(-1),(18. 58 ± 2. 09) μg·L^(-1),(87. 93 ± 8. 57) AU·L^(-1),which showed stat

关 键 词：肝肿瘤 原癌基因 甲胎蛋白类 凝血酶原 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤]