原发性肝癌患者血清血管内皮生长因子和甲胎蛋白的表达及临床意义

Clinical significance and expression of serum VEGF and AFP in primary hepatocarcinoma

目的探讨原发性肝癌(PHC)患者血清血管内皮生长因子(VEGF)和甲胎蛋白(AFP)的表达和临床意义。方法分别用ELISA法及微粒子酶免化学发光分析法检测30例健康对照、31例肝硬化和146例PHC患者血清VEGF及AFP含量,分析VEGF、AFP及二者联合检测与PHC的诊断价值和临床分期及预后的关系。结果VEGF水平(pg/ml)PHC组(398.4±153.1)与肝硬化组(178.6±97.5)和健康对照组(166.8±84.2)比较,差异有统计学意义(P<0.01),VEGF和AFP对PHC诊断的敏感性和特异性分别为(71.23%/73.29%)和(80.64%/83.87%),VEGF和AFP之间无相关性,二者联合检测可提高对PHC诊断的敏感性(91.81%)和准确度(90.40%)。PHC患者VEGF水平与肿瘤大小呈正相关(P<0.01),PHC术后转移和复发患者血清VEGF明显升高(P<0.05),TNMⅢ、Ⅳ期患者血清VEGF水平也明显高于TNMⅠ、Ⅱ期患者(P<0.01)。结论血清VEGF与AFP联合测定可作为诊断PHC和判断其预后的重要指标。

Objective To explore the clinical significance and expression of serum vascular en dothelial growth factor （VEGF） and alpha-fetoprotein （AFP） in primary hepatocarcinoma （PHC）. Methods By using ELISA serum VEGF and AFP levels were determined in 146 patients with PHC, 31 patients with liver cirrhosis and 30 healthy controls. The relationship among VEGF and AFP and clinical indexes were analyzed. Results The serum VEGF （pg/ml） levels in PHC group （398. 4 ±153.1）were significantly higher than those in liver cirrhosis group （178.6±97.5）and in healthy control group （166.8±84.2）（P〈0.01）. VEGF/AFP diagnostic sensitivity was 71.23%/73.29% ,specificity was 80. 64%/83. 87% in PHC. The sensitivity raised to 91. 81%, accuracy to 90. 40% with combined detection of VEGF and AFP. There was no relationship beween VEGF and AFP. The levels of serum VEGF in the patients with PHC were strongly associated with tumor size（P〈0.01 ）. Serum VEGF showed a significant elevation in the patients with remote metastasis, recurrent PHC and TNM Ⅲ , Ⅳ stages （P〈0.01）. Conclusion The detection of serum VEGF and AFP might provide a significant index marker for PHC diagnosis and a predictor of prognosis.