中晚期肝癌患者血清血管内皮生长因子、乏氧诱导因子-1α和同型半胱氨酸联合检测的临床价值

Clinical value of combined detection of homocysteine, vascular endothelial growth factor and hypoxia inducible factor - la in serum of patients with advanced liver cancer

目的 探讨血管内皮生长因子（VEGF）、乏氧诱导因子-1α（HIF-1α）、同型半胱氨酸（Hcy）联合检测对中晚期肝癌患者明确诊断的价值。方法采用酶联免疫吸附试验（ELISA）和放射免疫分析（RIA）79例中晚期肝癌、肝病患者血清组及30例健康对照组中VEGF、Hcy和HIF-1α含量。结果 各组肿瘤标志物Hcy、HIF-1α、VEGF检测结果显示，健康对照组患者分别为（10.5±5.6）、（22.59±2.14）、（166.8±84.2） μg/L，急性肝炎组患者分别为（202.5±41.5）、（65.39±6.54）、（168.0±85.3） μg/L，慢性活动性肝炎组患者分别为（218.2±50.6）、（58.46±6.50）、（170.0±87.6） μg/L，肝硬化组分别为（298.4±60.2）、（63.51±6.65）、（178.3±97.5） μg/L，中晚期肝癌组分别为（417.9±92.8）、（173.67±14.19）、（398.4±153.1） μg/L。中晚期肝癌患者血清中Hcy、VEGF、HIF-1α水平显著高于健康对照组和肝病患者组（t＝7.418、5.131和6.438，P＝0.001、0.001和0.005）。各种组合检测中，Hcy＋HIF-1α＋VEGF组合的敏感性、特异性、准确性和阳性预测值均较高，分别为93.67%、87.45%、83.43%和90.12%，与Hcy＋HIF-1α、Hcy＋VEGF组和HIF-1α＋VEGF组比较，差异有统计学意义（P＝0.031、0.037、0.013）。结论 Hcy、VEGF和HIF-1α联合检测可有效提高中晚期肝癌诊断的敏感性和准确性。

Objective To investigate the value of combined detection of vascular endothelial growth factor （VEGF）, hypoxia inducible factor-1α （HIF-1α） and homocysteine （Hcy） in patients with advanced liver cancer.Methods The contents of VEGF, Hcy and HIF-1α in 79 patients with advanced liver cancer and liver disease were analyzed by enzyme linked immunosorbent assay （ELISA） and radio immunoassay （RIA）, and in the control group of 30 cases.Results Each group of tumor markers Hcy, HIF-1α and VEGF test results showed that the health of patients in the control group （10.5±5.6）, （22.59±2.14）, （166.8±84.2） μg/L, respectively. Acute hepatitis patients （202.5±41.5）, （65.39±6.54）, （168.0±85.3） μg/L, respectively. Chronic active hepatitis patients （218.2±50.6）, （58.46±6.50）, （170.0±87.6） μg/L, respectively. Cirrhosis group were （298.4±60.2）, （63.51±6.65）, （178.3±97.5） μg/L, respectively. Advanced liver cancer group respectively （417.9±92.8）, （173.67±14.19）, （398.4±153.1） μg/L, respectively. The serum levels of Hcy, VEGF and HIF-1α in patients with advanced liver cancer were significantly higher than those in healthy controls and patients with liver disease （t=7.418, 5.131 and 6.438, P=0.001, 0.001 and 0.005）. The sensitivity, specificity, accuracy and positive predictive value of Hcy＋ HIF-1α＋ VEGF were higher in various combinations, is 93.67%, 87.45%, 83.43% and 90.12%, respectively. Compared with Hcy＋ HIF-1α group, Hcy＋ VEGF group and HIF-1α＋ VEGF group, the difference was statistically significant （P=0.031, 0.037, 0.013）.Conclusion 3 kinds of tumor markers in the diagnosis and treatment of advanced liver cancer, has a certain clinical value. The combination of Hcy, VEGF and HIF-1α can improve the sensitivity and accuracy of the diagnosis of advanced liver cancer.