血清IL-17A与干扰素γ诱导蛋白10在原发性肝癌中的表达及临床意义

Expression of serum IL-17A and interferon gamma-inducible protein 10 in primary liver cancer and its clinical significance

目的:探讨血清IL-17A与干扰素γ诱导蛋白10(IP-10)在原发性肝癌中的表达及临床意义。方法:收集2015年1月至2017年12月我科收治的原发性肝癌患者182例(实验组)及健康体检者50例(对照组),检测两组受试者血清IL-17A、IP-10值,比较两组血清IL-17A、IP-10水平差异,分析血清IL-17A、IP-10对原发性肝癌早期诊断的预测价值。结果:实验组患者术前血清IL-17A、IP-10水平分别高于对照组血清IL-17A、IP-10水平(P<0.05);实验组患者术后血清IL-17A、IP-10水平分别低于实验组患者术前血清IL-17A、IP-10水平(P<0.05);原发性肝癌患者不同病理组织分型间血清IL-17A、IP-10水平相比,差异具有统计学意义(P<0.05);原发性肝癌Ⅲ期患者的血清IL-17A、IP-10水平分别高于原发性肝癌Ⅰ、Ⅱ期患者的血清IL-17A、IP-10水平(P<0.05)。多因素分析结果示:血清TBil、AST、ALT、AFP、IL-17A、IP-10水平升高是原发性肝癌发生的独立危险因素。ROC曲线示:血清IL-17A曲线下面积为0.793,敏感度和特异度分别为0.827和0.619;IP-10曲线下面积为0.757,敏感度和特异度分别为0.796和0.714;血清IL-17A、IP-10联合检测曲线下面积为0.883,敏感度和特异度分别为0.898和0.810。结论:血清IL-17A、IP-10水平升高在原发性肝癌病情进展中起重要作用,可作为原发性肝癌早期诊断预测指标之一。

Objective:To investigate the expression and clinical significance of serum IL-17A and interferon gamma-inducible protein 10(IP-10)in primary liver cancer.Methods:A total of 182 patients with primary liver cancer(experimental group)and 50 healthy subjects(control group)were enrolled from January 2015 to December 2017.The serum levels of IL-17A and IP-10 were detected in the two groups.The difference of serum IL-17A and IP-10 levels between the two groups was compared,and the predictive value of serum IL-17A and IP-10 for early diagnosis of primary liver cancer was analyzed.Results:The preoperative levels of serum IL-17A,IP-10 in the experimental group was higher than that of serum IL-17A and IP-10 in the control group(P<0.05).The postoperative levels of serum IL-17A and IP-10 in the experimental group were lower than those preoperative levels of serum IL-17A and IP-10 in the experimental group(P<0.05).There were significant differences in serum IL-17A and IP-10 levels between different pathological tissue types of patients with primary liver cancer(P<0.05).The levels of serum IL-17A and IP-10 in stageⅢof primary liver cancer were higher than that of serum IL-17A and IP-10 in stageⅠandⅡof patients with primary liver cancer(P<0.05).Multivariate analysis showed that elevated serum TBil,AST,ALT,AFP,IL-17A,and IP-10 levels were indenpendent risk factors for primary liver cancer.The ROC curve showed that the area under the serum IL-17A curve was 0.793,and the sensitivity and specificity were 0.827 and 0.619,respectively.The area under the IP-10 curve was 0.757,and the sensitivity and specificity were 0.796 and 0.714,respectively.The area under the serum IL-17A combined with IP-10 was 0.883,and the sensitivity and specificity were 0.898 and 0.810,respectively.Conclusion:The elevated levels of serum IL-17A and IP-10 play an important role in the progression of primary liver cancer,and can be used as one of the early diagnostic indicators for primary liver cancer.