血管内皮生长因子对原发性肝癌的预测分析

Study on Diagnostic Value of Vascular Endothelial Growth Factor for Primary Hepatocellur Carcinoma

目的：探讨血管内皮生长因子（VEGF）对原发性肝细胞癌（PHC）临床诊断的价值。方法：选择21例PHC及36例肝硬化患者作为研究对象,采用酶联免疫吸附方法检测其血清VEGF表达水平,分析其与甲胎蛋白（AFP）的相关性及对PHC发生的判断价值。结果：PHC患者血清VEGF表达水平高于肝硬化患者,肝硬化患者高于健康对照组（Hc=19.672,P〈0.05）;血清VEGF与AFP呈正相关（r2=0.488,P〈0.05）;血清VEGF、AFP预测PHC发生的接受者操作特性曲线（ROC）为0.819和0.774,二者均能预测PHC发生（P〈0.05）;以VEGF≥106.6 pg/mL和AFP≥30.06 ng/mL作为预测指标,ROC为0.76（495%,CI为0.633~0.866）,其特异性达86.1%;以血清VEGF和AFP为参数,拟合预测PHC发生的Logistic二元回归方程,模型方程拟合优度高（χ2=6.097,P〈0.05）,预测PHC发生的准确率达78.9%。结论：VEGF和AFP可用于预测PHC发生,如二者联合作为预测因素,其特异性和准确性均较高。

Objective： To study the clinical value of vascular endothelial growth factor（VEGF） for primary hepatocellur carcinoma（PHC）. Methods： 21 patients with PHC, 36 patients with liver cirrhosis and 10 healthy controls were enrolled in the study. VEGF was detected by ELISA. The relationship between VEGF and AFP and their predicting value for the happening of PHC was analyzed. Results： The level of serum of VEGF in the patients with PHC was higher than that in liver cirrhosis, and that in liver cirrhosis was higher than that in healthy controls（He= 19.672,P〈0.05）. The positive correlation was found between VEGF and AFP（r^2= 0.488,P〈0.05）. The area under the ROC of VEGF, AFP predicting PHC was 0.819 and 0.774 respectively （all P〈 0.05）. Combined VEGF≥ 106.6 pg/mL with AFP≥30.06 ng/mL as a parameter predicting PHC, the area under the ROC was 0.764（95%,CI： 0.633~0.866）, the specificity was 86.1%, the logistic binary regression equation with VEGF and AFP had high goodness-of-fitting（χ^2=6.097, P〈0.05）, and the accuracy was 78.9%.Conclusion： Both VEGF and AFP all could predict occurrence of PHC, and the combination of two. If taken as predictors together, they had very high specificity and accuracy.