肝癌患者血清中透明质酸、层黏蛋白、Ⅲ型前胶原的测定及其诊断价值

Analysis and evaluation of hyaluronic acid, lamini and tape Ⅲ procollagen for diagnosis of hepatic carcinoma

目的了解透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PCⅢ)3项肝纤维化指标在原发性肝癌和转移性肝癌血清中的变化,并探讨肝纤维化、肝肿瘤和肝功能指标三者之间的相关关系。方法正常对照组30例、原发性肝癌组28例、转移性肝癌组23例。采用放射免疫法测定51例原发性和转移性肝癌病人血清中的HA、LN、PCⅢ3项肝纤维化指标,罗氏Elecsys1010电化学发光全自动免疫分析仪测定甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原(Ca-199)3项肿瘤指标,同时用美国贝克曼库尔特公司Synchron LX20全自动生化分析仪测定天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰氨转酞酶(-γGT)3项肝功指标。结果51例病人HA、LN、PCⅢ水平均明显高于正常对照组(P<0.01)。HA、AFP、肝功能指标在原发性肝癌组明显升高,与转移性肝癌组比较有统计学差异(P<0.01);LN、PCⅢ原发性肝癌组和转移性肝癌组比较无统计学差异(P>0.05);CEA、Ca-199在转移性肝癌组明显升高,和原发性肝癌组比较有统计学差异(P<0.05)。肝纤维化指标与肝肿瘤指标和肝功能指标之间的相关分析无相关关系(P>0.05)。结论3项肝纤维化指标的测定对了解肝内占位性病变的纤维化程度有一定帮助,但肝纤维化指标与肝肿瘤指标和肝功能指标之间无相关关系。

Objective To study the change of HA, LN, PC Ⅲ in the serum of primary hepatic carcinoma and hepatic metastases and the relationship between the hepatic serum fibrosis and hepatic carcinoma or hepatic function index. Methods For the controls （30）,primary hepatic carcinoma （28）,hepatic metastases（ 23 ） , hepatic fibrosis serum index including HA, LN, PCⅢ were detected by RIA in 51 primary hepatic carcinoma and hepatic metastases while hepatic carcinoma index including AFP, CEA, Ca-199 were detected by ROSS chemical luminescent immunoassay in 51 serum samples. In addition hepatic function index including AST, ALT, γ-GT were detected by Backman in 51 serum samples. Results The levels of HA, LN, PC Ⅲ were found significantly higher in 51 patients than those of the controls . The levels of HA, AFP, hepatic function index were significantly higher in primary hepatic carcinoma than hepatic metastases（ P 〈 0.01）. No significient difference was shown betwwen the level of LN, PCⅢ of primary hepatic carcinoma and hepatic metastases（ P 〉 0.05）. The level of CEA,Ca-199 was remarkable higher in hepatic metastases than primary hepatic carcinoma （ P 〈 0.05）, whereas no significient relationship was found between fibrosis index and carcinoma could well reflect the degree index or function index . Conclusion Three fibrosis indexes including HA, LN, PC Ⅲ of development of hepatofibrosisin liver carcinoma. However no significant relationship was found between the serum fibrosis index and carcinoma index or function index.