原发性肝细胞癌血流量与血清高迁移率族蛋白B1及微血管侵犯相关性的初步研究

Correlation of blood flow in hepatocellular carcinoma with serum high mobility group box protein 1 and microvascular invasion: A preliminary study

背景肿瘤的发生发展与其微循环血供、高迁移率族蛋白B1(high mobility group box protein 1, HMGB1)表达水平等因素关系密切.术前准确预测原发性肝细胞癌(hepatocellular carcinoma, HCC)的微血管侵犯(microvascular invasion, MVI)情况有着重要临床意义.目的运用超声造影定量分析HCC的血流量特征,探讨其与血清HMGB1及MVI的相关性.方法选取在我院行手术切除的78例HCC患者作为研究对象.根据术后病理结果分为:微血管侵犯组(45例)和无微血管侵犯组(33例).所有患者均在术前3 d内行超声造影检查,运用时间-强度曲线测定HCC增强强度(enhancement intensity, EI)、曲线下面积(area under the curve, AUC).采用酶联免疫吸附法测定患者血清HMGB1水平及血管内皮生长因子(vascular endothelial growth factor, VEGF)水平.术后测定组织标本的微血管密度(microvessel density, MVD).分析EI、AUC与血清HMGB1水平的相关性.结果微血管侵犯组EI、AUC均明显高于无微血管侵犯组,差异有统计学意义(P<0.05);微血管侵犯组血清HMGB1水平、VEGF水平以及MVD明显高于无微血管侵犯组,差异有统计学意义(P<0.05);EI、AUC分别与血清HMGB1水平呈正相关(r=0.729, r=0.759,P <0.05).结论超声造影能定量分析HCC血流量状态,其血流量参数与血清HMGB1水平相关性良好,可为临床术前无创性评估HCC微血管侵犯提供有价值的参考.

BACKGROUND The occurrence and development of tumors are closely related to microcirculation and high mobility group box protein 1(HMGB1) expression levels.It is very important to predict the microvascular invasion(MVI) of hepatocellular carcinoma(HCC) before operation.AIM To quantitatively analyze the blood flow characteristics of HCC by contrast-enhanced ultrasound(CEUS),and to explore the correlation of the blood flow with HMGB1 and MVI.METHODS Seventy-eight patients with HCC who underwent surgical resection were included.According to the postoperative pathological results,the patients were divided into either an MVI group(45 cases) or a non-MVI group(33 cases).All patients underwent CEUS 3 d before operation.The enhancement intensity(EI) and area under the curve(AUC) in HCC were measured by timeintensity curve analysis.Serum HMGB1 and vascular endothelial growth factor(VEGF) were measured by enzyme-linked immunosorbent assay.Microvessel density was measured after operation.The correlation between EI, AUC,and serum HMGB1 was analyzed.RESULTS EI and AUC in the MVI group were significantly higher than those in the non-MVI group(P <0.05).Serum HMGB1 and VEGF were significantly higher than those of the non-MVI group(P <0.05).EI and AUC were positively correlated with serum HMGB1(r=0.729 and 0.759,P<0.05).CONCLUSION CEUS can quantitatively analyze the blood flow in HCC,and its blood flow parameters have a good correlation with serum HMGB1,which can provide reference for noninvasive assessment of MVI before operation.