肝癌患者血清IGFBP1的表达及其临床意义

Expression of Serum IGFBP1 Level in Patients with Hepatocellular Carcinoma and its Clinical Significance

目的探究肝癌患者血清胰岛素生长因子结合蛋白1(insulin growth factor binding protein 1,IGFBP1)的表达变化及其临床意义。方法回顾性选取于武汉大学中南医院就诊的体检正常对照个体(CTL组,n=32)、慢性乙型肝炎患者(CHB组,n=32)和肝癌患者(HCC组,n=64)。采用-80℃冻存上述研究对象的血清标本,酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测血清中IGFBP1的水平,3组间差异比较采用单因素方差分析,事后两两比较采用LSD-t检验;不符合正态分布的计量资料多组间差异比较采用Kruskal-Wallis H检验,并一步两两比较;计数资料组间差异比较采用Fisher确切概率法;相关性分析采用Spearman法,受试者工作特征(receiver operating characteristic,ROC)曲线用于评价血清IGFBP1的诊断效能,二元Logistic回归分析用于血清IGFBP1水平对肝癌的风险评估。结果HCC组患者的血清IGFBP1表达水平明显高于CTL组和CHB组,差异有统计学意义(H=29.427,P<0.001);乙型肝炎病毒(hepatitis B virus,HBV)感染不影响血清IGFBP1水平。血清IGFBP1水平与经典的肝癌血清蛋白标志物甲胎蛋白(alpha fetoprotein,AFP)存在较强的正相关关系(r=0.484,P<0.001),其诊断效能为(AUC=0.773,95%CI:0.693~0.852,P<0.001)。二元Logistic回归分析结果显示,血清IGFBP1升高是肝癌的风险因子(OR=1.049,95%CI:1.014~1.084,P=0.005)。结论肝癌患者血清中IGFBP1水平升高是肝癌的风险因素,对肝癌的诊断具有一定的临床价值。

Objective To investigate the expression changes of serum insulin growth factor binding protein 1(IGFBP1)in patients with hepatocellular carcinoma(HCC)and its clinical significance.Methods Normal control individuals(CTL group,n=32),patients with chronic hepatitis B infection(CHB group,n=32)and patients with HCC(HCC group,n=64)were retrospectively selected from Zhongnan Hospital of Wuhan University.Serum samples of the above subjects were frozen at-80℃.The level of serum IGFBP1 was detected by enzyme-linked immunosorbent assay(ELISA).The comparison among the three groups was performed by one-way ANOVA.The further comparison between the two groups was examined by LSD-t test.Data with non-normal distribution was compared by Kruskal-Wallis H test,and further compared between the two groups.Fisher exact probability test was used to compare the differences between groups of counting data.Spearman method was used for correlation analysis.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum IGFBP1.Risk evaluation of serum IGFBP1 in HCC was performed by binary Logistic regression analysis.Results The serum IGFBP1 level of HCC patients was significantly higher than that of CTL group and CHB group,the difference was statistically significant(H=29.427,P<0.001).Hepatitis B virus(HBV)infection did not affect the serum IGFBP1 level.Serum IGFBP1 level had a positive correlation with alpha fetoprotein(AFP)(r=0.484,P<0.001),a typical serum biomarker for HCC.Serum IGFBP1showed a good diagnostic efficacy(AUC=0.773,95%CI:0.693-0.852,P<0.001).Binary Logistic regression analysis showed that serum IGFBP1 elevation was a risk factor for HCC(OR=1.049,95%CI:1.014-1.084,P=0.005).Conclusion Increased serum IGFBP1seems to be a risk factor for HCC,which has certain clinical value in the diagnosis of HCC.