血清醛酮还原酶家族1成员B10(AKR1B10)对肝细胞癌的诊断价值  

Value of serum Aldo-keto reductase family 1 member B10(AKR1B10)in diagnosis of hepatocellular carcinoma

作　　者：杜云玲 时长江 高方媛 张梦娜 王玲玲 张竹青 明颖 谢守军[1] DU Yunling;SHI Changjiang;GAO Fangyuan;ZHANG Mengna;WANG Lingling;ZHANG Zhuqing;MING Ying;XIE Shoujun(Department of Clinical Laboratory,South Branch of The Affiliated Hospital of Chengde Medical University,Chengde,Hebei 067000,China;First Department of Integrated Traditional Chinese and Western Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]承德医学院附属医院南院区检验科,河北承德067000 [2]首都医科大学附属北京地坛医院中西医结合一科,北京100015

出　　处：《临床肝胆病杂志》2025年第4期684-689,共6页Journal of Clinical Hepatology

基　　金：承德市科技计划项目(202109A064);河北省政府资助临床医学优秀人才培养项目(ZF2024237)。

摘　　要：目的通过分析血清醛酮还原酶家族1成员B10(AKR1B10)在肝细胞癌(HCC)患者中的表达情况,为HCC的临床诊断提供新的有价值的血清学标志物。方法选取2020年5月—2024年5月承德医学院附属医院就诊的102例HCC患者、119例肝脏良性疾病患者、132例其他恶性肿瘤患者和148例健康体检者为研究对象。通过酶联免疫吸附法和化学发光法分别检测血清AKR1B10和AFP水平。非正态分布的计量资料两组间比较采用Mann-Whitney U检验,Kruskal-Wallis H检验用于多组间的比较和进一步两两比较,计数资料组间比较采用χ^(2)检验,利用受试者操作特征曲线(ROC曲线)下面积(AUC)评估检验效能。结果四组间AKR1B10表达差异有统计学意义[HCC组:3053.79(1475.67~4605.86)pg/mL,肝脏良性疾病组:1324.42(659.68~2023.88)pg/m L,其他恶性肿瘤组:660.68(377.56~2087.77)pg/m L,健康组:318.30(82.73~478.82)pg/m L,H=240.86,(P<0.001)]。进一步两两比较,HCC组明显高于肝脏良性疾病组、其他恶性肿瘤组和健康组(P值均<0.001)。HCC组与其他三组的ROC曲线结果显示,诊断HCC的最佳血清AKR1B10浓度界值为1584.97 pg/mL,AUC为0.86,95%CI:0.82~0.90,敏感度为74.3%,特异度为85.2%。相较于单一指标,AKR1B10与AFP联合应用,可以提高HCC诊断的敏感度(81.8%)和特异度(91.4%)。AKR1B10诊断早中期HCC患者的AUC为0.84,95%CI:0.78~0.90,敏感度为76.2%,特异度为81.2%。AKR1B10诊断AFP阴性HCC患者的AUC为0.85,95%CI:0.77~0.92,敏感度为81.6%,特异度为79.9%。结论AKR1B10是一种有潜力的诊断HCC的新型血清学标志物,与AFP联合使用,可能提高HCC(尤其是早中期HCC和AFP阴性HCC)患者的检出率。Objective To investigate the expression of serum Aldo-keto reductase family 1 member B10(AKR1B10)in patients with hepatocellular carcinoma(HCC)in northern China,and to provide a new and valuable biomarker for the clinical diagnosis of HCC.Methods This study was conducted among 102 patients with HCC,119 patients with benign liver disease,and 132 patients with other malignant tumors who attended The Affiliated Hospital of Chengde Medical University and 148 healthy individuals who underwent physical examination from May 2020 to May 2024.ELISA and chemiluminescence were used to measure the serum levels of AKR1B10 and alpha-fetoprotein(AFP).The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the Kruskal-Wallis H test was used for comparison between three groups and further comparison between two groups;the chi-square test was used for comparison of categorical data between groups.The area under the ROC curve(AUC)was used to assess diagnostic efficiency.Results The expression level of AKR1B10 was 3053.79(1475.67-4605.86)pg/mL in the HCC group,1324.42(659.68-2023.88)pg/mL in the benign liver disease group,660.68(377.56-2087.77)pg/mL in the other malignant tumor group,and 318.30(82.73-478.82)pg/mL in the healthy group,with a significant difference between the four groups(H=240.86,P<0.001),and further comparison between two groups showed that the HCC group had a significantly higher level than the other three groups(all P<0.001).The ROC curve analysis of the HCC group and the other three groups showed that serum AKR1B10 had an optimal cut-off value of 1584.97 pg/mL in the diagnosis of HCC,with an AUC of 0.86(95%confidence interval[CI]:0.82-0.90),a sensitivity of 74.3%,and a specificity of 85.2%.Compared with each indicator alone,a combination of AKR1B10 and AFP could improve the sensitivity(81.8%)and specificity(91.4%)of HCC diagnosis.AKR1B10 had an AUC of 0.84(95%CI:0.78-0.90)in the diagnosis of patients with early-or middle-stage HCC,with a sensitivity of 76

关 键 词：癌 肝细胞 醛酮还原酶家族1成员B10 甲胎蛋白类 

分 类 号：R735.7[医药卫生—肿瘤]