原发性肝细胞癌患者血清多效生长因子水平及临床诊断价值评估  

Expression and Clinical Significance of Detection of Pleiotrophin in Patients with Primary Hepatic Carcinoma

作　　者：景晓华 杨学军 雒夏 JING Xiaohua;YANG Xuejun;LUO Xia(Shizuishan Maternal and Child Health Family Planning Service Center,Shizuishan,753000 China;Shizuishan Third People's Hospital,Shizuishan 753400,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]石嘴山市妇幼保健计划生育服务中心,石嘴山753000 [2]石嘴山市第三人民医院,石嘴山753400 [3]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2019年第10期993-998,共6页Journal of Ningxia Medical University

基　　金：中国肝炎防治基金会天晴肝病研究基金（TQGB20180223）

摘　　要：目的探讨检测原发性肝细胞癌患者血清多效生长因子(PTN)水平并评估其临床诊断价值。方法 88例肝细胞癌患者为肝癌组,49例肝硬化患者为肝硬化组,47例为健康体检者(健康对照组)。采用ELISA法检测3组血清PTN水平;Real-time PCR和Western blot检测24对肝细胞癌及癌旁组织中PTN mRNA及其蛋白的表达;曲线回归分析肝癌患者血清PTN与临床特征的相关性;斯皮尔曼分析肝癌患者血清PTN与甲胎蛋白(alpha fetoprotein,AFP)的相关性,绘制ROC曲线分析血清PTN诊断肝癌的效能。结果肝癌组血清PTN(501.24±183.30) pg·mL-1高于肝硬化组(293.69±72.40)pg·mL-1和健康对照组(295.94±131.33)pg·mL-1(P均<0.01),肝硬化组与健康对照组比较差异无统计学意义(P>0.05);肝癌组织PTN mRNA及蛋白的表达高于癌旁组织(P<0.01);AFP阳性肝癌患者血清PTN水平(527.11±173.38)pg·mL-1高于AFP阴性患者(320.06±150.25) pg·mL-1(P<0.01);肿瘤直径≥5cm的肝癌患者血清PTN表达(536.72±173.45)pg·mL-1高于肿瘤直径<5cm的肝癌患者(388.01±170.87)pg·mL-1(P<0.01),同时肝癌有转移患者的血清PTN水平(591.77±158.21)pg·mL-1高于无转移(414.72±163.93)pg·mL-1患者(P<0.01),TNM分期Ⅲ~Ⅳ期患者(569.05±173.56)pg·mL-1亦高于TNM分期Ⅰ~Ⅱ期患者(423.49±163.81)pg·mL-1(P<0.01),但不同年龄、性别、肿瘤是否复发的血清PTN水平差异均无统计学意义(P均>0.05);曲线回归分析发现肝癌患者血清PTN水平分布与血小板、白蛋白呈负相关,血清AST/ALT比值与血清PTN水平呈正相关(P均<0.05);血清PTN诊断肝癌的AUC为0.809,AFP诊断肝癌AUC为0.842;血清PTN诊断肝癌的敏感度和特异度分别为64.8%、89.4%,AFP为67.0%和96.0%。结论肝癌患者PTN表达增高,血清PTN含量与肝癌肿瘤大小、转移与否、TNM分期有关;可协助AFP提高原发性肝细胞癌诊断效能。Objective To investigate the expression of serum pleiotrophin(PTN)in liver cancer and its clinical diagnostic value. Methods Eighty-eight patients with hepatocellular carcinoma were in the liver cancer group,49 patients with liver cirrhosis were in the cirrhosis group,and 47 patients with healthy examination were normal.The levels of PTN in the three groups were detected by ELISA. The expressions of PTN m RNA and protein in liver cancer and adjacent tissues were detected by Real-time PCR and Western blot. The correlation between serum PTN and clinical features in liver cancer patients was analyzed by curve regression. The correlation between serum PTN and AFP in patients with liver cancer was analyzed Spearman,and the ROC curve was used to analyze the efficacy of serum PTN in the diagnosis of liver cancer. Results The level of serum PTN in the carcinoma group(501.24±183.30)pg·mL-1 was significantly higher than that in the cirrhosis group(293.69±72.40)pg·mL-1 and the control group(295.94±131.33)pg·mL-1. There was no difference in the cirrhosis group and control group(P>0.05). PTN m RNA and protein expression in hepatic carcinoma were significantly higher than adjacent tissues(P<0.01).The serum PTN level(320.06±150.25)pg·mL-1 of AFP negative hepatic carcinoma patients was significantly different from AFP positive patients(527.11±173.38)pg·mL-1(P<0.01). Tumor diameter(≥5 cm)serum PTN expression(536.72±173.45)pg·mL-1 was significantly higher than tumor diameter(<5 cm)patients(388.01±170.87)pg·mL-1(P<0.01). Serum PTN level in patients with metastasis(591.77±158.21)pg·mL-1,and of in TNM stage III-IV(569.05±173.56)pg·mL-1 were significantly higher than in patients without metastasis(414.72±163.93)pg·mL-1 and in TNM stage I-II(423.49±163.81)pg·mL-1(P<0.01).However,there was no significant difference in serum PTN levels in the age,sex and tumor recurrence in cancer group(P>0.05).Curve regression analysis showed that the distribution of serum PTN levels in hepatic carcinoma was negatively correlated

关 键 词：多效生长因子 原发性肝细胞癌 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤]