层粘连蛋白γ2在肝细胞癌诊断和微血管侵犯中的表现  

Performance of laminin γ2 in diagnosing hepatocellular carcinoma and in microvascular invasion

作　　者：吴书锐 马奔 赵洁[2] 丁伟伟[3] 胡明根[2] Wu Shurui;Ma Ben;Zhao Jie;Ding Weiwei;Hu Minggen(Medical School of Chinese People’s Liberation Army(PLA),Beijing 100853,China;Faculty of Hepato-Pancreato-Biliary Surgery,Chinese PLA General Hospital,Beijing 100853,China;Department of Gastroenterology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院研究生院,北京100853 [2]解放军总医院肝胆胰外科医学部,北京100853 [3]解放军总医院消化内科医学部,北京100853

出　　处：《中华肝胆外科杂志》2023年第3期161-164,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的:分析层粘连蛋白γ2(LAMC2)诊断肝细胞癌的价值以及在不同微血管侵犯(MVI)肝细胞癌患者中的差异。方法:前瞻性收集2021年1月至2022年3月在解放军总医院肝胆胰外科医学部行手术治疗的100例肝细胞癌患者资料,纳入肝细胞癌组,其中男性80例,女性20例,年龄(55.7±11.1)岁。收集同时间段同一医院17例行手术治疗且术前无肝硬化肝血管瘤患者资料,纳入对照组,其中男性6例,女性11例,年龄(42.8±9.8)岁。酶联免疫吸附法检测术前血清中LAMC2含量。比较两组甲胎蛋白、LAMC2,并绘制受试者工作特征(ROC)曲线比较两指标诊断肝细胞癌的效能。比较不同MVI患者LAMC2差异。结果:肝细胞癌组LAMC2为1334.2(838.9,2656.0)pg/ml、甲胎蛋白为19.0(4.6,778.6)μg/L,高于对照组375.2(221.2,691.7)pg/ml、3.3(2.5,3.5)μg/L,差异均有统计学意义(Z=-4.32、-4.63,均P<0.001)。LAMC2诊断肝细胞癌的ROC曲线下面积为0.829(95%CI:0.748-0.892),甲胎蛋白为0.852(95%CI:0.769-0.910),两个指标联合诊断为0.949(95%CI:0.911-0.988)。LAMC2与甲胎蛋白联合诊断肝细胞癌效能优于LAMC2、甲胎蛋白单独诊断(ROC曲线下面积比较:Z=3.15、3.07,P=0.002、0.002)。肝细胞癌组患者依据MVI分组,M0组61例、M1(低危)组25例、M2(高危)组14例,LAMC2含量依次为1168.6(834.3,2521.4)pg/ml、942.2(614.0,2056.6)pg/ml、3128.4(1852.7,7191.3)pg/ml。M2组LAMC2高于M0组和M1组,差异均有统计学意义(Z=-3.46、-3.32,P=0.001、0.004)。结论:LAMC2与甲胎蛋白联合诊断肝细胞癌效能高于单独诊断。不同MVI肝细胞癌患者LAMC2血清含量存在差异。Objective To analyze the value of lamininγ2(LAMC2)in the diagnosis of hepatocellular carcinoma(HCC)and the difference in patients with different types of microvascular invasion(MVI).Methods A cohort of 100 patients with HCC who underwent surgical treatment at the Faculty of Hepato-Pancreato-Biliary Surgery,Chinese PLA General Hospital from January 2021 to March 2022 were prospectively enrolled.There were 80 males and 20 females,aged(55.7±11.1)years.The data of 17 patients with hepatic hemangioma without cirrhosis who underwent operation at the same hospital during the study period were collected to serve as the control group(6 males,11 females),aged(42.8±9.8)years.LAMC2 in serum was determined by enzyme linked immunosorbent assay.The levels of alpha-fetoprotein(AFP)and LAMC2 were compared between the two groups,and receiver operating characteristic(ROC)curves were drawn to compare these two markers in the diagnosis of HCC.The LAMC2 of different MVI patients were compared.Results The levels of LAMC2 and AFP were 1334.2(838.9,2656.0)pg/ml and 19.0(4.6,778.6)μg/L in the HCC group,which were significantly higher than 375.2(221.2,691.7)pg/ml and 3.3(2.5,3.5)μg/L in the control group(Z=-4.32,-4.63,both P<0.001).The areas under the ROC curve were 0.829(95%CI:0.748-0.892)for LAMC2 and 0.852(95%CI:0.769-0.910)for AFP,and was 0.949(95%CI:0.911-0.988)for using both in the diagnoses.The diagnostic efficacy of combining LAMC2 and AFP was significantly better than that of LAMC2 alone and AFP alone(area under ROC:Z=3.15,3.07,P=0.002,0.002).When the patients were divided into the M0 group(61 patients),the M1 Group(25 patients)and the M2 Group(14 patients)based on MVIs,the concentrations of LAMC2 were 1168.6(834.3,2521.4)pg/ml,942.2(614.0,2056.6)pg/ml and 3128.4(1852.7,7191.3)pg/ml,respectively.The level of LAMC2 in the M2 group was significantly higher than that in the M0 and M1 groups(Z=-3.46,-3.32,P=0.001,0.004).Conclusion The diagnostic efficacy of LAMC2 combined with AFP for HCC was significantly higher than that of eit

关 键 词：癌 肝细胞 诊断 甲胎蛋白类 层粘连蛋白 微血管侵犯 

分 类 号：R735.7[医药卫生—肿瘤]