血管内皮生长因子与热休克蛋白90α和胸苷激酶1在肝恶性肿瘤临床诊断中的应用价值探讨

Vascular endothelial growth factor,heat shock protein 90α,and thymidine kinase 1 in clinical diagnosis of malignant liver tumors

目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)、热休克蛋白90α(heat shock protein 90α,HSP90α)和胸苷激酶1(thymidine kinase 1,TK1)在肝恶性肿瘤临床诊断中的应用价值。方法选取2018年7月至2020年6月安徽医科大学附属巢湖医院收治的肝恶性肿瘤患者[32例,男性23例,女性9例,年龄(47.80±11.78)岁]、肝良性疾病患者[32例,男性21例,女性11例,年龄(49.24±13.22)岁]和同时期体检健康人[32例,男性22例,女性10例,年龄(48.32±12.65)岁]作为研究对象,检测所有研究对象初诊血清样本的VEGF、HSP90α和TK1水平,分析其在肝恶性肿瘤、肝良性疾病患者和健康人群血清中的表达情况及其鉴别诊断效能。结果肝恶性肿瘤组VEGF、HSP90α和TK1水平分别为284.58(78.40,604.37)pg/ml、122.03(88.76,197.16)μg/ml和2.21(0.89,3.60)pmol/L,肝良性疾病组VEGF、HSP90α和TK1水平分别为120.58(67.64,196.38)pg/ml、77.32(53.43,103.65)μg/ml和0.71(0.23,1.84)pmol/L,健康对照组VEGF、HSP90α和TK1水平分别为122.54(63.52,183.43)pg/ml、65.38(49.86,98.57)μg/ml和0.81(0.29,1.78)pmol/L。经Mann-Whitney检验,肝恶性肿瘤组VEGF、HSP90α和TK1水平均高于肝良性疾病组和健康对照组(均P<0.05)。ROC曲线分析显示VEGF、HSP90α和TK1均具有一定的辅助诊断价值(均P<0.05),当VEGF、HSP90α和TK1分别取临界值198.53 pg/ml、106.16μg/ml和1.88 pmol/L时获得最大的诊断效能,ROC曲线下面积分别为0.855、0.895和0.811。结论VEGF、HSP90α和TK1是肝恶性肿瘤临床辅助诊断的良好指标,值得临床推广应用。

Objective To investigate the value of vascular endothelial growth factor(VEGF),heat shock protein 90α(HSP90α),and thymidine kinase 1(TK1)in the clinical diagnosis of malignant liver tumors.Methods Thirty-two(47.80±11.78)years old patients with malignant liver tumors,including 23 males and 9 females,and thirty-two(49.24±13.22)years old patients with benign liver diseases,including 21 males and 11 females,who were treated at Chaohu Hospital Affiliated to Anhui Medical University,as well as thirty-two(48.32±12.65)years old healthy examinees during the same period,including 22 males and 10 females were selected as the study objects.The levels of VEGF,HSP90α,and TK1 in the serum of all the objects were detected and analyzed.The efficacies of VEGF,HSP90α,and TK1 in the differential diagnosis of the patients with liver malignant tumors,the patients with benign liver diseases,and the healthy examinees were analyzed.Results The levels of VEGF,HSP90α,and TK1 were 284.58(78.40,604.37)pg/ml,122.03(88.76,197.16)μg/ml,and 2.21(0.89,3.60)pmol/L in the malignant liver tumor group,were 120.58(67.64,196.38)pg/ml,77.32(53.43,103.65)μg/ml,and 0.71(0.23,1.84)pmol/L in the benign liver disease group,and were 122.54(63.52,183.43)pg/ml,65.38(49.86,98.57)μg/ml,and 0.81(0.29,1.78)pmol/L in the healthy controls.According to Mann-Whitney test,the levels of VEGF,HSP90α,and TK1 in the malignant liver tumor group were significantly higher than those in the benign liver disease group and those in the healthy control group(all P<0.05).ROC analysis showed that VEGF,HSP90α,and TK1 had auxiliary diagnostic value for malignant liver tumors(all P<0.05).when VEGF,HSP90α,and TK1 took their cut-off values of 198.53 pg/ml,106.16μg/ml,and 1.88 pmol/L,the maximum diagnostic efficiency was obtained,and their areas under the ROC curve(AUC)were 0.855,0.895,and 0.811,respectively.Conclusion VEGF,HSP90α,and TK1 are good indicators for the clinical auxiliary diagnosis of malignant liver tumors,so they are worthy of clinical application.