肝癌患者血浆Spc25蛋白表达水平及临床意义  

Expression and clinical significance of detection of plasma Spc25 protein in patients with hepatic carcinoma

作　　者：魏建波 张丽君 杨桃桃 崔艳霞 杨玉秀 WEI Jian-bo;ZHANG Li-jun;YANG Tao-tao;CUI Yan-xia;YANG Yu-xiu(Grade 2015, Xinxiang Medical University, Xinxiang 453003, China)

机构地区：[1]新乡医学院,河南新乡453003 [2]郑州大学人民医院河南省人民医院消化内科,郑州450003 [3]郑州大学人民医院河南省人民医院急诊科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2018年第6期541-544,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省重点科技攻关项目(132102310444)

摘　　要：目的探讨血浆Spc25蛋白表达在肝癌诊断中价值。方法 34例肝癌(小肝癌15例,非小肝癌19例)患者为肝癌组,28例肝硬化患者为肝硬化组,25例体检健康者为对照组。采用ELISA法检测3组血浆Spc25蛋白和甲胎蛋白(alpha fetoprotein,AFP)水平,分析血浆Spc25蛋白表达水平与肝癌患者临床特征的关系;Pearson法分析肝癌患者血浆Spc25与AFP的相关性,绘制ROC曲线,分析Spc25蛋白诊断肝癌的效能。结果肝癌组血浆Spc25蛋白表达水平[(106.66±64.38)μg/L]高于肝硬化组[(36.97±34.21)μg/L]和对照组[(26.40±25.60)μg/L](P<0.05),肝硬化组与对照组比较差异无统计学意义(P>0.05);AFP阴性(AFP<20μg/L)肝癌患者血浆Spc25蛋白表达水平[(106.58±59.03)μg/L)]与AFP阳性(AFP≥20μg/L)肝癌患者[(106.86±81.50)μg/L]比较差异无统计学意义(P>0.05);血浆Spc25蛋白表达水平在肝癌有远处转移[(143.80±66.37)μg/L]及TNM分期Ⅲ期[(103.97±62.10)μg/L]、Ⅳ期者[(143.80±66.37)μg/L]高于无远处转移[(86.40±54.66)μg/L]、TNM分期Ⅰ+Ⅱ期者[(74.23±47.59)μg/L](P<0.05);不同年龄、性别、肿瘤直径、肝炎病毒感染状况及有无门静脉血管侵犯肝癌患者血浆Spc25蛋白表达水平比较差异均无统计学意义(P>0.05);Spc25蛋白诊断肝癌和小肝癌的AUC分别为0.830、0.818,与AFP诊断肝癌和小肝癌的AUC(0.836、0.732)比较差异均无统计学意义(P>0.05);Spc25蛋白诊断肝癌的灵敏度(82.4%)、特异度(75.7%)与AFP(73.5%、73.5%)比较差异均无统计学意义(P>0.05);Spc25蛋白诊断小肝癌的灵敏度(80.0%)、特异度(57.1%)与AFP(66.7%、50%)比较差异均无统计学意义(P>0.05);Spc25蛋白诊断AFP阴性肝癌的AUC为0.816,灵敏度为77.8%,特异度43.8%;Spc25蛋白联合AFP诊断肝癌的AUC(0.947)与AFP单独诊断比较差异无统计学意义(P>0.05),诊断小肝癌的AUC(0.962)大于AFP单独诊断(P<0.05)。结论肝癌患者血浆Spc25蛋白表达增高,且其表达与肝癌远处转移、TNM分期有关;Spc25Objective To detect the expression of plasma Spc25 protein and its value to the diagnosis of hepatic carcinoma.Methods Thirty-four patients with hepatic carcinoma（cancer group）including 15 patients with small liver cancer and 19 with non-small liver cancer,28 with liver cirrhosis（cirrhosis group）and 25 healthy volunteers（control group）were detected the levels of plasma Spc25 protein and alpha fetoprotein（AFP）by ELISA method.The correlation between hepatic carcinoma and Spc25 protein was analyzed.And the efficiency of Spc25 protein on the diagnosis of hepatic carcinoma was assessed by ROC curve.Results The level of Spc25 protein was significantly higher in cancer group（（106.66±64.38）μg/L）than that in cirrhosis group（（36.97±34.21）μg/L）and control group（（26.40±25.60）μg/L）（P〈0.05）,and there was no significant difference between cirrhosis group and control group（P〉0.05）.The level of Spc25 showed no significant difference between AFP-negative patients（AFP〈20μg/L）（（106.58±59.03）μg/L）and AFP-positive patients（≥20μg/L）（（106.86±81.50）μg/L）in cancer group（P〉0.05）.The levels of Spc25 protein in patients with distant metastasis（（143.80±66.37）μg/L）,and in TNM stage Ⅲ（（103.97±62.10）μg/L）and Ⅳ（（143.80±66.37）μg/L）were significantly higher than those in patients with no distant metastasis（（86.40±54.66）μg/L）and in TNM stageⅠ/Ⅱ（（74.23±47.59）μg/L）（P〈0.05）.There were no significant differences in the Spc25 levels in the age,sex,cancer diameter,hepatic virus infection and portal vein invasion in cancer group（P〉0.05）.The AUCvalues of Spc25 protein for hepatic carcinoma and small liver cancer were 0.830 and 0.818,showing no significant difference from those of AFP for hepatic carcinoma and small liver cancer（0.836,0.732）（P〉0.05）.The sensitivity and specificity of Spc25 protein for hepatic carcinoma were 82.4%and 75.7%,showing no significant differnce from those o

关 键 词：肝癌 Spc25 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]