联合检测血清E-钙粘连蛋白和AFP在肝癌中的表达及术后复发的意义

To study expression and recurrence significance of uniting soluble E-cadherin and AFP pre-and postoperative in hepatocellular carcinoma

背景与目的:E-钙粘连蛋白(E-cadherin,EC)是维持上皮细胞的极性及细胞间连接的糖蛋白,被认为与肝细胞癌的发生、发展密切相关。本研究联合检测肝细胞癌患者手术前后血清可溶性E-钙粘连蛋白(soluble E-cadherin,sEC)和甲胎蛋白(alpha-fetoprotein,AFP)的表达,探讨其临床意义及在复发中的价值。方法:采用酶联免疫吸附(ELISA)和放射免疫法检测(RIA)检测105例肝细胞癌患者手术前后及70例健康人sEC和AFP的水平,分析术前sEC和AFP的水平与临床病理特征的关系,并对手术后复发的47例肝癌患者的sEC和AFP水平进行分析。结果:肝细胞癌患者术前sEC和AFP水平显著高于健康人,手术1周后sEC和AFP水平较术前显著下降。术前sEC水平与肝细胞癌TNM分期密切相关(P<0.01),与肿瘤分级,有无门静脉癌栓、有无包膜相关(P<0.05),与年龄、肿瘤大小无关(P>0.05)。术前AFP水平与肝细胞癌TNM分期密切相关(P<0.05),与年龄、肿瘤大小、肿瘤分级、有无门静脉癌栓、有无包膜无相关性(P>0.05)。当确诊为肝癌复发时,sEC水平也明显高于术后(P<0.01)。结论:肝细胞癌术前sEC水平与临床分期有关,可作为一种肝细胞癌预后和复发预测因子。联合检测sEC、AFP可以更好地预测肝癌的复发。

Background and purpose： E-cadherin （EC） is a type of glycoprotein, which could maintain epithelial polarity and cell-cell junction. It is thought to be associated with the development and progression of hepatocellular carcinoma （HCC）. The study aimed to detect expression of uniting detection sEC and AFP before and after operation in patients, and to monitor recurrence of postoperative. Methods： The levels of sEC and AFP in 105 HCC patients were tested by enzyme linked immunosorbent assay （ELISA） and radioimmunoassay （RIA） before and after operation as well as in 70 healthy controls. Theirs correlation with clinical and pathological factors was analyzed. We analyzed the level of plasma sEC and AFP of 47 patients who had been suffered from the hepatocellular carcinoma operation and relapse. Results： The levels of sEC and AFP in HCC patients before operation were significantly higher than in controls, which declined significantly one week after operation. The sEC level before operation showed significant correlation with TNM staging （P〈0.01）, edmondson grade, the carcerous thrombi within the portal vein and the capsule of carcinoma （P〈0.05）, but not with age of patients or the tumor size （/〉〉0.05）. While AFP only correlation with TNM staging （P〈0.05）, not with others factors （P〉0.05）. When the recurrence was confirmed, the level of sEC was much higher significantly than the level postoperation （P〈0.01）. Conclusion： The levels of sEC in HCC patients before operation are closely related with prognosis and recurrence of HCC. The unites detection of sEC＋AFP may he a predictive factor for recurrence of postoperation.