血清可溶性细胞间黏附因子-1和P-选择素在肝癌中的水平及临床意义

The clinical significance of serum soluble intercellular adhesion molecule-1 and P-selectin in hepatocellular carcinoma

目的研究可溶性细胞间黏附因子-1(sICAM-1)与P-选择素(P-selectin)在肝细胞癌(HCC)患者血清中的表达及与肝癌复发、转移的关系。方法采用ABC-ELISA法对78例肝癌患者治疗前和治疗后第30天血清中sICAM-1和P-selectin的水平进行检测,同时测定甲胎蛋白(AFP)浓度,并用SPSS10.0统计软件及受试者操作特征(ROC)曲线进行分析,评价其临床应用价值。结果治疗前后血清中sICAM-1和P-selectin含量均高于健康对照组,并随临床TNM分期增加而升高,治疗有效组外周血中sICAM-1和P-selectin显著下降,而无效组则升高,治疗后二者的浓度转移和复发组均高于未复发组和转移组(P分别<0.05及<0.01)。sICAM-1和P-selectin与AFP的表达相关性表明,HCC患者血清sICAM-1、P-selectin的水平与AFP含量均呈正相关(分别为r=0.874,P<0.05;r=0.892,P<0.01)。对sICAM-1、P-selectin和AFP的ROC曲线分析提示,sICAM-1的诊断效能最高,AFP次之,P-selectin较差。结论sICAM-1和P-selectin与HCC生长关系密切,与HCC的侵袭、转移有关,血清sICAM-1和P-selectin有可能成为HCC辅助诊断、病情发展及疗效观察方面有价值的指标,可作为反映肝癌复发、转移潜能的生物学指标。

Objective To investigate the serum expression levels of soluble intercellular adhesion molecule-1 （sICAM-1） and P-selectin, and to explore the relationship between the two indices and recurrence as well as metastasis of hepatocellular carcinoma （HCC）. Methods ABC-ELISA was applied to detecting the levels of sICAM-1 and P-selectin in serum of 78 patients with HCC before and after therapy （day 30 after treatment）, meanwhile, alpha fetoprotein （AFP） concentration was measured. SPSS10.0 software and receiver operating characteristic （ROC） cdrve were adopted to analyze the differences of the above indices, and evaluate their clinical value. Results The levels of sICAM-1 and P-selectin of patients with HCC were significantly higher than those of normal control group （P〈 0.01）, and kept increasing with TNM staging. The levels of peripheral blood sICAM-1 and P selectin decreased markedly in effective group, while in ineffective group, their levels were elevated. After therapy, the levels of serum sICAM-1 and P-selectin were both higher in recurrence group and metas tasis group than those of non-recurrence group and non-metastasis group. Correlation analysis showed there were positive correlation between sICAM-1 as well as P-selectin and AFP （r=0. 874 ,P〈0. 05 ;r =0. 892,P〈0.01 reapectively）. ROC curve analysis showed the diagnostic efficacy of sICAM-1 was optimal, followed by AFP and P-selectin. Conclusion sICAM-1 and P-selectin correlates closely with development,recurrence or metastasis of hepatocellular carcinoma （HCC）. Serum sICAM-1 and P-selectin may be used as important biological parameters infelecting recurrence or metastasis trend of HCC, contributing to auxiliary diagnosis, surveillance of progression of disease and observation of therapeutic effects and they are maybe potential predictors of metastatic recurrence in HCC.