IRX5在原发性肝细胞癌患者血清中的表达及临床意义

Expression and clinical significance of IRX5 in serum of patients with primary hepatocellular carcinoma

目的探讨原发性肝细胞癌(HCC)患者血清中易洛魁家族同源盒基因5(IRX5)的表达及临床意义。方法收集117例HCC患者和52例肝脏良性疾病患者的血清样本及相应临床资料,以同时段46例健康体检者的血清样本作为对照组。采用酶联免疫吸附试验检测各组血清IRX5表达,采用德国罗氏公司全自动化学发光免疫分析仪(Cobas e411)和西门子ADVIA2400全自动生化分析仪分别检测血清甲胎蛋白(AFP)和丙氨酸氨基转移酶(ALT)水平。比较各组血清IRX5、AFP和ALT水平差异,观察不同临床特征HCC患者的血清IRX5水平,分析HCC患者血清IRX5与ALT、AFP的相关性,评价血清IRX5对HCC的诊断效能。结果HCC组血清IRX5表达量高于肝脏良性疾病组及对照组(P均<0.05),肝脏良性疾病组及对照组之间IRX5表达水平无统计学差异(P>0.05)。HCC组血清IRX5表达量与血清AFP水平呈正相关(r=0.27,P<0.05),与血清ALT水平无关(r=-0.082,P>0.05)。IRX5和AFP诊断HCC的受试者工作特征曲线下面积分别为0.738(95%CI:0.667~0.808)、0.838(95%CI:0.781~0.895);二者最佳临界值分别为27.41、7.55 ng/mL,诊断HCC的敏感性分别为73%、77.4%,特异性分别为72.7%、79.5%。血清IRX5与AFP比较,诊断HCC的ROC曲线下面积、敏感性、特异性均无统计学差异(P均>0.05)。结论IRX5在HCC中表达上调,其表达与血清AFP呈正相关,有望成为诊断HCC的候选标志物之一。

Objective To investigate the expression and clinical significance of iroquois family homeobox gene 5(IRX5)in serum of patients with primary hepatocellular carcinoma(HCC).Methods Totally 117 serum samples with HCC(HCC group)and 52 serum samples with benign liver diseases(benign liver diseases group)were collected,and 46 serum samples from healthy subjects were used as the control group.Serum IRX5 expression was detected by enzymelinked immunosorbent assay(ELISA).Serum alpha fetoprotein(AFP)and alanine aminotransferase(ALT)levels were detected by Roche automatic chemiluminescence immunoanalyzer(Cobas E411)and Siemens ADVIA2400 automatic biochemical analyzer,respectively.The levels of serum IRX5,AFP and ALT were compared among the groups,and the levels of serum IRX5 in HCC patients with different clinical characteristics were observed.The correlation between serum IRX5,ALT and AFP in HCC patients was analyzed,and the diagnostic efficacy of serum IRX5 in HCC patients was evaluated.Results The level of serum IRX5 was higher in the HCC group than in the benign liver disease group and control group(both P<0.05),and there was no significant difference in the level of IRX5 between benign liver disease group and control group(P>0.05).In the HCC group,serum IRX5 expression was positively correlated with serum AFP level(r=0.27,P<0.05),but was not related to serum ALT level(r=-0.082,P>0.05).The area under receiver operating characteristic(ROC)curve of IRX5 and AFP in the diagnosis of HCC was 0.738(95%CI:0.677-0.808)and 0.838(95%CI:0.781-0.895),respectively.The optimal cut-off values were 27.41 ng/mL and 7.55 ng/mL,respectively.The sensitivities in diagnosis of HCC were 73%and 77.4%,and and specificities were 72.7%and 79.5%,respectively.There were no significant differences in the area under the ROC curve,sensitivity,or specificity between serum IRX5 and AFP in the diagnosis of HCC(all P>0.05).Conclusion The expression of IRX5 is up-regulated in HCC,and its expression is positively correlated with serum AFP,which is expected to be one of the candidate markers for the diagnosis of HCC.