检测肝性腹水sCD44v6和血管内皮生长因子的诊断试验评价

Assessing the value of sCD44v6 and VEGF on diagnosis in hepatogenic ascites

目的通过检测不同病因的肝性腹水中可溶性CD44v6(sCD44v6)和VEGF水平,评价其在鉴别诊断原发性肝癌腹水和肝硬化腹水中的应用价值。方法采集临床不同病因腹水患者80例,经确诊结果分为两组:肝硬化组(49例)、原发性肝癌组(31例)。分别用双抗体夹心ELISA法检测各组腹水中sCD44v6、VEGF的水平,绘制受试者工作特征(ROC)曲线,评价此两项指标在肝性腹水定性诊断中的临床价值。结果原发性肝癌组的sCD44v6、VEGF水平高于肝硬化对照组,差异有显著性(P<0.05)。诊断原发性肝癌腹水以sCD44v6值56.37ng/ml为临界值时,灵敏性83.8%、特异性83.6%;以VEGF值225.60pg/ml为临界值时,灵敏性87.1%、特异性85.7%;两指标联合检测可明显捉高肝癌恶性腹水的检出率。结论原发性肝癌腹水sCD44v6和VEGF的水平显著增高。sCD44v6和VEGF对肝硬化腹水和原发性肝癌腹水有明显的鉴别诊断意义。

Objective To evaluate the clinical value of ascites sCD44v6 and VEGF levels in differential diagnosis of hepatocellular carcinoma and cirrhosis. Methods Ascites specimens were collected from 49 patients with cirrhosis and 31 patients with hepatocellular carcinoma in clinic. sCD44v6 and VEGF levels in ascites wer e investigated by double sandwich enzyme_linked immunosorbent assay(ELISA).Receiv er operating characteristic(ROC) curve was used to assess their value in qualita tive diagnosis of hepatogenic ascites. Results sCD44v6 and VEGF levels were significantly higher in patients with hepatocellula r carinoma than that in benign controls(P<0.05).Using a cut_off value of 5 6.37 ng/ml for sCD44v6,the sensitivity of the marker was 83.8% and the specifi ci ty was 83.6%, respectively,which of VEGF were 225.60 pg/ml,87.1% and 85.7%,r espectively.T he positive rate could be elevated significantly in patients with hepatocell ular carcinoma when sCDv6 and VEGF were simultaneously detected. Conclusion sCD44v6 and VEGF levels increase extremely in malignant hepatogenic ascites.The detections of sCD44v6 and VEGF are useful in differentiating patients with hepat ocellular carcinoma and cirrhosis.