肝细胞癌的免疫组化、分子检测及MRI诊断评价

Role of Immunohistochemistry,Molecular Detection and MRI in the Diagnosis of Hepatocellular Carcinoma

目的 分析肝细胞癌的免疫组化、分子检测及MRI诊断效果。方法 选择160例肝细胞癌患者作为研究对象,将其纳入病例组;另选择同期体检疑似肝细胞癌患者160例,将其纳入对照组。免疫组化检查磷脂酰肌醇蛋白多糖-3(glypican-3,GPC-3)和细胞角蛋白(cytokeratin-19,CK-19),酶联免疫吸附法检测血管内皮生长因子(vascular endothelial growth factor,VEGF)、成纤维生长因子(fibroblast growth factors,FGF)水平,依据MRI影像进行病情诊断。结果 病例组GPC-3阳性率为71.86%、CK-19阳性率为66.25%,高于对照组(P<0.05)。病例组患者VEGF水平(441.58±13.02)pg/ml、FGF水平(0.69±0.06)ng/ml,高于对照组(P<0.05)。病例组Ⅲ~Ⅳ期患者GPC-3阳性率为89.29%、CK-19阳性率为98.21%,高于Ⅰ~Ⅱ期患者(P<0.05);Ⅲ~Ⅳ期患者VEGF[(519.51±20.12)pg/ml]、FGF[(0.79±0.11)ng/ml]水平高于Ⅰ~Ⅱ期患者(P<0.05)。病例组患者MRI检出率和阳性率高于对照组(P<0.05);病例组中Ⅰ~Ⅱ期、Ⅲ~Ⅳ期MRI诊断阳性率差异比较无统计学意义(P>0.05)。五项联合诊断鉴别效能最高(P<0.05)。结论肝细胞癌患者GPC-3、CK-19阳性率较高,VEGF、FGF高表达,与MRI联合诊断能提升肝癌诊断价值,建议使用。

Objective To investigate the effect of immunohistochemistry,molecular detection and MRI in the diagnosis of hepatocellular carcinoma.Methods 160 patients with hepatocellular carcinoma were enrolled,and set as case group,meantime,another 160 cases of suspected hepatocellular carcinoma during healthy examinations were set as the control group.Factors including glypican-3(GPC-3),cytokeratin-19(CK-19),vascular endothelial growth factor(VEGF)and fibroblast growth factor(FGF)were detected using immunohistochemistry,and all patients received MRI examinations.Results The positive rates of GPC-3 and CK-19 were 71.86% and 66.25% in case group,which were significantly higher than those of the control group(P0.05).Compared with single or paired diagnosis,the diagnostic efficacy of GPC-3,CK-19,VEGF,FGF combined with MRI examinations was the highest(P<0.05).Conclusion Patients with hepatocellular carcinoma have high positive rates of GPC-3 and CK-19 as well as elevated expression levels of VEGF and FGF,moreover,combined detection of the four indicators and MRI can effectively improve the diagnostic value of hepatocellular carcinoma.