肝细胞肝癌患者血清PF4、VEGF、HIF-1α及Lp(a)的表达及临床意义

Clinical Significance of PF4,VEGF,HIF-1a and Lpα in Sera of Patients with Hepatocellular Carcinoma

目的探讨血小板第4因子(PF4)、血管内皮生长因子(VEGF)、乏氧诱导因子-1α(HIF-1α)及脂蛋白(a)[Lp(a)]在肝细胞肝癌(hepatocellular carcinoma,HCC)患者血清中的表达及其临床意义。方法收集2014年3月~2016年12月年本院确诊的慢性乙型肝炎(chronic hepatitis B,CHB)102例、肝硬化(livercirrhosis,LC)51例、HCC患者37例及健康对照组(health control,HC)186例,采用免疫增强比浊法测定受试者血清中Lp(a)浓度,同时采用酶联免疫吸附试验(ELISA)测定血清PF4、HIF-1a和VEGF含量,并对检测结果进行统计分析。结果 PF4、VEGF、HIF-1α和Lp(a)浓度在HCC组明显高于CHB、LC和HC组,差异均有统计学意义(t=6.185~15.916,P<0.001~0.05),且Ⅲ期HCC明显高于Ⅰ期和Ⅱ期,差异均有统计学意义(t=7.951~19.086,P<0.001~0.05),CHB、LC和HC组血清PF4、VEGF及HIF-1α浓度的差异无统计学意义(t=0.371~0.892,P>0.05);LC组Lp(a)浓度明显低于其他组,差异均有统计学意义(t=6.176~9.452,P<0.05),且Ⅲ级LC明显低于Ⅰ级和Ⅱ级,差异均有统计学意义(t=4.945~6.067,P<0.05)。结论 PF4、VEGF、HIF-1α和Lp(a)浓度在HCC血清中明显增高,且随临床分期/级越大,浓度增幅越高,可作为临床HCC诊断及分期依据;Lp(a)浓度LC组明显降低,可作为LC诊断及与HCC鉴别诊断依据。

Objective To investigate the levels and clinical significance of platelet factor4(PF4),vascular endothelial growth factor(VEGF),hypoxia inducible factor-1α(HIF-1α)and lipoproteinα(Lpα)in hepatocellular carcinoma(HCC).Method The investigation included102inpatients of chronic hepatitis B(HCB),51of liver cirrhosis,37of HCC,and186subjects of healthy controls(HC)between2014and2016.All samples were detected with immune enhanced turbidimetric method for serum concentration of Lpαand with ELISA for seral PF4,HIF-la and VEGF.Results The PF4,VEGF,HIF-1a and Lpαconcentrations in HCC patients were obviously higher than thoseof CHB and LC patients,and HC as well(P<0.001~0.05),showing a stage-dependent increase of the markers teste(t=7.951-19.086,P<0.001-0.05).No remarkable variation was noted of PF4,VEGF,and HIF-1αin the three groups(P>0.05).Lpαlevel,however,was found to be higher in LC group than in the other groups(P<0.05),reversely showing a stage-dependent decrease(P<0.05).Conclusions PF4,VEGF,HIF-1αand Lpαlevels are significantly elevated in the sera of HCC patients,based on which a differential diagnosis between LC and HCC can be made.