肝癌组织和血清中钙囊素的表达及其意义

The expressions of calcium binding protein and its clinical significances in hepatocelluar carcinoma tissue and bloodplasma

目的研究人肝癌组织及血清中钙囊素（S100A11）的表达及其临床意义。方法免疫组织化学法检测46例肝癌及其癌旁组织中S100A11表达，比较肝癌与癌旁组织中S100A11的阳性率，分析肝癌组织中S100A11表达水平与各临床参数之间的关系；同时检测肝癌（62例）、肝硬化（32例）、慢性肝炎（30例）患者及健康体检者（28名）血清中S100A11浓度，比较S100A11浓度与甲胎蛋白（AFP）、γ-谷氨酰转肽酶同工酶Ⅱ（GGT-Ⅱ）诊断肝癌的灵敏性及特异性。结果S100A11在肝癌组织中的表达阳性率（78．3％）显著高于癌旁组织（19．6％，P〈0．01），其表达水平与分化程度相关，分化程度越低表达水平越高。根据ROC曲线，当确定诊断界值为7．3μg／L时，S100A11在肝癌患者血清中的阳性率为30．6％，明显高于肝硬化、慢性肝炎及健康人（P值均〈0．05）。肝癌患者血清中S100A11与AFP、GGT-Ⅱ均无相关性，联合检测三项指标对肝癌诊断有互补性，可使诊断敏感性提高至84．5％。结论S100A11可能与肝癌的发生发展有关。联合检测S100A11与AFP和GGT-Ⅱ可提高对肝癌的诊断敏感度。

Objective To explore the expression of calcium binding protein （S100A11） and its clinical significances in human hepatocellular carcinoma （HCC） tissue and blood plasma. Methods The expressions of S100A11 in 46 cases of HCC tissues and their paracancerous tissues were detected by immunohistochemistry. The relationship between S100A11 expression level in HCC tissues and clinical parameters was analyzed. The S100A11 expression levels in blood plasma of HCC patients （62 cases）, liver cirrhosis patients （32 cases）, chronic hepatitis patients （30 cases） and healthy subjects （30 cases） were detected. The sensitivity and specificity of S100A11, alpha fetoprotein （AFP） and Y-glutamyl transpeptidase Ⅱ （GGT-Ⅱ ） in HCC diagnosis were compared. Results The positive rate of S100A11 in HCC tissue （78.3 %） was significantly higher than that in paracancerous tissues （19.6%） （P〈0.05）. The expression level was correlated with the degree of differentiation, the lower differentiation degree with the higher expression level. According to ROC curve, if the cutoff points for diagnosis was set at 7. 3μg/L, the positive rate of S100A11 in HCC patients＇ blood plasma was 30.6 %, which was significantly higher than that in the blood plasma of patients with liver cirrhosis, patients with chronic hepatitis and healthy persons （P（0.05）. There was no correlation between S100A11 and AFP or GGT-I] in the blood plasma of HCC patients. These three indicators were complementary in HCC diagnosis, and the diagnostic sensitivity increased to 84.5% with combined detection. Conclusions S100A11 may be related to HCC genesis and development. The HCC diagnostic sensitivity may be increased with combined detection of S100A11, AFP and GGT 11.