血清铁及总铁结合力在原发性肝癌病程发展中的变化

Changes of serum iron and total iron binding capacity in the progress of primary liver cancer

目的探讨血清铁(SI)和总铁结合力(TIBC)在原发性肝癌发病进程中的变化及其临床意义。方法检测176例原发性肝癌不同病程患者的SI、TIBC的变化。结果将患者按照《原发性肝癌诊疗规范(2011年版)》TNM分期,其中ⅣB期31例,ⅣA期22例,ⅢC期23例,ⅢB期25例,ⅢA期32例,Ⅱ期21例,Ⅰ期22例,随着肝癌病程的进展,SI和TIBC的含量均逐渐下降(F=7.93和369.67,P<0.01)。将患者按照BCLC标准进行分期和评分:极早期39例,早期14例,中期48例,进展期53例,终末期22例,统计分析显示BCLC分期的performance status(PS)评分值与SI(r=0.306,P<0.01)和TIBC(r=0.854,P<0.01)的水平呈正相关。结论在原发性肝癌患者,SI和TIBC与原发性肝癌发病进程呈正相关,提示SI和TIBC对肝癌的病情发展可能存在临床监测意义。

Objective To investigate the changes of serum iron （SI）and total iron binding capacity （TIBC）in the clinical course of primary liver cancer and the clinical significance. Methods The changes of SI and TIBC were detected in patients with primary hepatic carcinoma at different stages. Results According to the standard for diagnosis and treatment of primary liver cancer in 2011,176 cases with primary liver cancer were staged as follows：31 cases at Ⅳ B （any T, any N, M1 ）, 22 cases at Ⅳ A （any T, N1M0） ,23 cases at ⅢC （T4N1M0） ,25 cases at ⅢB （T3bNOM0） ,32 cases at Ilia （T3aNOM0） ,21 cases at Ⅱ （T2NOM0） and 22 cases at [ （T1NOM0） ; the concentration of SI was （ 8.38±5.44）, （9.80 ± 3.68 ）, （ 15.32 ± 6.75 ）, （ 16. 89 ± 7.54 ）, （ 18.24± 10.36） ,（17.15 ± 10.00）, （20.34 ± 10. 13） μmol/L, respectively, and the concentration TIBC was （27.91 ±5.02）, （37.19 ± 1.41 ）, （40.63 ±1.03 ）, （ 44.44 ± 0.90）, （49.35± 1.90）, （ 54.92 ± 1.28 ）, （ 63.22 ± 5.34） μmol/L, respectively. With the progress of the disease, the concentration of SI and TIBC kept decreasing （ F = 7.93, P 〈 0.01 ; F = 369.67, P 〈 0.01 ）. BCLC and performance status（PS） scores were made to all the cases as well： 39 cases at very early stage（PS：0） ,14 cases at early stage （PS：0）, 48 cases at media stage （PS：0） ,53 cases at progressing stage （PS：1,17cases with PS of 1,16 cases with PS of 2 and 20 cases with PS of 3 ） and 22 at terminal stage（ PS： 4 ）. The statistical analysis revealed that there was a positive correlation between PS value and SI concentration（r =0.306,P 〈0.01）and between PS value and TIBC concentration（r =0. 854,P 〈0.01 ）. Conclusions The changes of SI and TIBC are in positive correlation with the progress of primary liver cancer,which indicates that SI and TIBC is of value in monitoring the progress of primary liver cancer.