血清NOV/CCN3在肝癌中的临床意义研究

Serum expression and clinical significance of Nov/CCN3 in human hepatocellular carcinoma

探讨肾母细胞瘤过度表达基因NOV/CCN3表达产物在肝病患者外周血中的水平及其在肝癌演进中的病理意义。采用ELISA方法共检测380例原发性肝细胞癌(HCC)患者,92例肝硬化(LC)患者和102例正常人血清中NOV蛋白表达水平,分析其表达与肝癌的临床病理学特征的关系。LC组NOV含量高于HCC组及正常对照组(P<0.001)。将LC组与正常对照组比较,以血清NOV水平做ROC曲线,曲线下面积为0.741,NOV在cutoff值为7.812ng/ml时敏感度为67.4%,特异度为73.5%。在HCC组中,NOV水平与肿瘤的TNM分期、肿瘤大小呈负相关。NOV对于AFP阴性人群的诊断效率经ROC曲线分析提示,曲线下面积为0.803,NOV在cutoff值为7.68ng/ml时,敏感度为83.8%,特异度为71.6%。NOV可辅助诊断肝硬化、肝癌,该分子可能与肝硬化发生相关并在肝癌的演进中发挥负性调控作用。

To investigate the expression of nephroblastoma overexpressed （NOV/ CCN3） gene in the serum of hepatocellular cancer （HCC） and liver cirrhosis （LC） and to evaluate the relationship between the level of NOV and the progression of hepatocellular carcinoma, a newly developed commercial assay for detection of NOV in the body fluids was adopted. We investigated levels of serum NOV in 380 samples of human HCC and, 92 samples of LC as well as 102 samples of healthy controls. The re lationship between NOV/ CCN3 levels and the clinical pathological features were also evaluated. The concentrations of NOV in LC was significantly higher than those in HCC and healthy controls （P^0. 001）. For distinguishing LC from healthy controls, NOV had a sensitivity of 67.4% and specificity of 73.5% [area under curve （AUC） ： 0. 741] at the cutoff level of 7. 812 ng/ml by applying receiver operating characteristic （ROC） curve analysis. In HCC group, the NOV concentration was negatively cor related with clinical-pathological features, including tumor size and TNM stage. The area under ROC curve （AUC） of NOV in AFP-negative population was 0. 803. The optimal cutoff point of NOV was 7.68 ng/ml, with the sensitivity being 83.8% and the specificity being 71.6%. In conclusion,NOV might be helpful in the differential diagnosis between liver cirrhosis and AFP- negative HCC, and may play a negative regulatory role in the evolution of HCC.