原发性肝癌患者肝动脉化疗栓塞术前后血清TK1和AFP水平的变化及意义

Changes in pre-and post-operative serum TK1 and AFP levels in patients with primary hepatocellular carcinoma undergoing arterial chemoembolization and its clinical significance

目的探讨原发性肝癌肝动脉化疗栓塞术(TACE)前后血清胸苷激酶1(TK1)和甲胎蛋白(AFP)的表达水平及其临床意义。方法选取2013年8月至2016年8月间湖南省肿瘤医院收治的45例行TACE手术原发性中晚期肝癌患者,按照术后有无发生转移将其分为未转移组33例和转移组12例,采用免疫印迹增强化学发光法检测患者治疗前后血清TK1水平,采用电化学发光法检测AFP水平。同时选取30例健康体检者为对照组。结果治疗前,未转移组和转移组患者血清TK1和AFP水平均高于对照组,差异均有统计学意义(均P<0.05);未转移组和转移组血清TK1和AFP水平比较,差异无统计学意义(P>0.05)。治疗后,未转移组患者血清TK1和AFP水平均低于治疗前,转移组患者血清TK1和AFP水平均高于治疗前,差异均有统计学意义(均P<0.05)。未转移组患者治疗前后,血清TK1与AFP之间呈正相关关系(r=0.739、0.571,P<0.05);转移组患者治疗前后,血清TK1和AFP之间呈正相关关系(r=0.622、0.513,P<0.05)。结论 TK1和AFP在原发性中晚期肝癌患者中呈高表达水平,治疗后发生转移时,TK1/AFP呈高表达;未发生转移时,呈低表达水平。联合检测血清TK1和AFP可作为评估原发性肝癌动脉化疗栓塞术治疗后疗效的重要指标。

Objective To explore the expression of serum thymidine kinase 1（ TK1） and alpha fetal protein（ AFP） before and after transcatheter arterial chemoembolization（ TACE） in patients with primary hepatocellular carcinoma and its significance. Methods Forty-five patients with median and advanced primary hepatocellular carcinoma undergoing TACE at Hunan Provincial Cancer Hospital from August 2013 to August 2016 were retrospectively analyzed. Patients were divided into a non-metastasis group（ 33 patients） and a metastasis group（ 12 patients） according to whether metastasis occurred after the surgery.The serum TK1 levels before and after TACE were detected by enhanced chemiluminescence and the serum AFP levels were detected by the electrogenerated chemiluminescence. At the same time,30 healthy individuals who had health exams were selected as the control group. Results The serum levels of TK1 and AFP were higher in the non-metastasis group and metastasis group than in the control group（ P〈0. 05）. No statistically significant difference was found in TK1 and AFP levels between the two groups（ P〈0. 05）. After TACE,the TK1,AFP levels were lower in the non-metastasis group than before TACE while TK1 and AFP levels were higher in the metastasis group than before TACE（ P〈0. 05）. Before and after TACE,the serum TK1 was positively associated with AFP in the non-metastasis group（ r = 0. 739,0. 571,P〈0. 05）. Before and after TACE,serum TK1 was positively associated with AFP in the metastasis group（ r = 0. 622,0. 513,P〈0. 05）. Conclusion TK1 and AFP are highly expressed in patients with median and advanced primary hepatocellular carcinoma,which are expressed highly when metastasis occurred and are expressed lowly after TACE. Combined detection of TK1 and AFP can be important indicators to evaluate the efficacy of TACE.