原发性肝癌患者血清IGFBP-3浓度的测定及临床意义

The detection and clinical significance of insulin-like growth factor binding protein-3 in the serum of patients with hepatocellular carcinoma

目的探讨原发性肝癌患者血清胰岛素样生长因子结合蛋白-3(IGFBP-3)浓度的变化及对其诊断和发病机制的意义。方法用酶联免疫法(ELISA)检测了25例原发性肝癌、10例正常对照、21例慢性肝炎(中度10例、重度11例)及11例肝硬化患者血清IGFBP-3的浓度。用单因素方差分析比较各组IGFBP-3的浓度,用成组设计的两样本均数比较的t检验比较肝癌患者组内区别。结果正常对照、慢性肝炎、肝硬化及肝癌患者血清IGFBP-3的浓度分别为(4891.63±1482.91)、(3192.67±779.86)、(1146.93±443.15)及(1760.61±958.88)ng/m l。肝癌患者中AFP阳性组与阴性组之间差异无统计学意义。无肝硬化基础的肝癌患者血清IGFBP-3浓度稍高于在肝硬化基础上发生的肝癌患者,但二者之间以及与肝硬化患者之间差异无统计学意义。结论血清IGFBP-3浓度的显著降低对肝癌的诊断有辅助意义,尤其是无慢性肝炎及肝硬化的患者。

Objective To investigate the detection and clinical significance of insulin -like growth factor binding protein -3 （1GFBP - 3 ） in the serum of patients with hepatocellular carcinoma（ HCC ）. Methods The serum IGFBP - 3 level was measured by enzyme linked im- munosorbent assay（ELISA） in 25 patients with HCC, 21 casess with chronic hepatitis （10 cases moderate degree, 1 lcases severe degree）, 11 cases with cirrhosis and 10 healthy controls. One -way ANOVA was used to analyse the IGFBP -3 level between different groups. The IGFBP - 3 level in HCC patients with or without cirrhosis was assessed using Student＇s t - tests. Results The serum IGFBP - 3 levels were （4891.63 ± 1482. 91 ）, （3192.67 ± 779. 86）, （1146. 93 ±443. 15） and （1760. 61 ± 958. 88） ng/ml in healthy controls, in patients with chronic hepatitis, cirrhosis and HCC, respectively. The IGFBP -3 level in HCC patients was significantly lower than that in healthy controls and patients with chronic hepatitis （ P 〈 0. 05 ）, and not than that in cirrhotic patients （ P 〉 0. 05）. There was no significant difference in the IGFBP - 3 level between the AFP positive and AFP negative HCC patients （ P 〉 0. 05 ）. The IGFBP - 3 level in HCC patients without cirrhosis was slightly higher than that in HCC patients with cirrhosis and cirrhotic patients without HCC （ all P 〉 0. 05）. Conclusion The significantly reduced serum IGFBP -3 level is helpful for the diagnosis of HCC, especially in patients without chronic hepatitis and cirrhosis.