炎性细胞因子检测在原发性肝癌患者预测及分期中的临床价值

Clinical value of inflammatory cytokine detection in predicting and staging of primary liver cancer patients

目的探讨研究白细胞介素1β(IL-1β)、IL-17A、IL-27、γ干扰素(interferon-γ,IFN-γ)、肿瘤坏死因子α(TNF-α)等检测在预测原发性肝癌患者的发生和临床分期中的应用价值。方法选择2012年8月—2015年12月台州市中西医结合医院收治的96例原发性肝癌患者作为研究对象,其中Ⅰ、Ⅱ期原发性肝癌组35例、Ⅲ期原发性肝癌组29例、Ⅳ期原发性肝癌组32例,另选择35例体检正常健康人作为对照组,分别检测和比较肝癌组和健康组血清中IL-1β、IL-17A、IL-27、IFN-γ、TNF-α水平的差异,并采用ROC曲线评估以上各细胞因子对原发性肝癌分期的预测效果。结果 IL-1β、IL-17A、IL-27、TNF-α等细胞因子对原发性肝癌患者诊断的ROC曲线下面积分别为0.857、0.998、0.982、0.982。IL-27对原发性肝癌患者不同分期的预测结果最好,AUC为0.940,cut-off值为307.05 pg/ml,敏感性为87.50%,特异性为89.06%,阳性预测值为83.56%,阴性预测值为75.50%,Youden指数为0.77。结论 IL-1β、IL-17A、IL-27、IFN-γ、TNF-α等细胞因子水平在原发性肝癌患者与健康人之间有明显差异(P<0.05),且IL-27对原发性肝癌患者的分期具有诊断意义。

Objective To study the clinical value of IL-1β, IL-17A, IL-27, IFN-γ, TNF-α detection in predicting and staging of primary liver cancer patients. Methods Ninety-six primary liver cancer patients （ stage I and II 35 cases, stage III 29 cases, stage IV 32 cases） were selected as research subjects from August,2012 to December,2015. Thirty-five cases of normal healthy people were chosen to be as the control group. The serum IL-1β, IL-12p70, IL-17A, IL-22, IL-23, IL-27 ,IL-2,IL-4,IL-12, IFN-γ level were detected and compared in the liver cancer group and the control group. The ROC curves were used to assess the effect of each eytokines above in predicting the primary liver cancer stages. Results The area under the ROC curve of IL-1 β, IL-17A, IL-27, TNF-α to diagnose primary liver cancer patients were 0. 857, 0. 998,0. 982,0. 982. The effect of forecasting the primary liver cancer patients＇ stage was the best, with the AUC 0. 940, cut-off value 307.05 pg/ml, the sensitivity 87.50% , specificity 89.06% , positive predictive value 83.56% , negative pre- dictive value 75.50%, and Youden index 0.77. Conclusion The levels of IL-1β, IL-4, IL-17A, IL-27, IFN-γ, TNF-α are significantly different（ P 〈 0.05 ） between the primary liver cancer patients and healthy people, and IL-27 has a good fu- ture in diagnosing the stage of primary liver cancer patients.