【摘要】 目的探讨乙型肝炎病毒(hepatitis B virus,HBV)相关甲胎蛋白(AFP)阴性肝细胞癌(hepatocellular carcinoma,HCC)患者血清鞘脂表达谱改变及其诊断价值。方法采用高效液相色谱法与串联质谱法,对15例乙肝相关AFP阴性HCC患者和49例乙肝肝硬化患者的外周血清中61种鞘脂的表达水平进行检测,并对结果进行统计分析。结果 61种血清鞘脂中,有14种鞘脂在两组间差异有统计学意义(P<0.05)。OPLSDA分析结果表明,Cer(d18∶1/8∶0)-1-P、Sphingosine(d17∶1)-1-P和Sphingosine(d18∶1)-1-P是区分乙肝相关AFP阴性HCC和乙肝肝硬化的潜在标志物,其在AFP阴性HCC患者中的表达水平分别为217.74pmol/0.1 ml、58.28 pmol/0.1 ml和62.99 pmol/0.1 ml,均显著高于乙肝肝硬化患者的表达水平(P<0.05)。将三种鞘脂纳入Logistics回归分析,结果表明,Cer(d18∶1/8∶0)-1-P与乙肝相关AFP阴性HCC独立相关(OR=0.667,95%CI:0.481~0.923,P<0.05),其预测诊断乙肝相关AFP阴性HCC的灵敏度为81.6%,特异度为86.7%。结论外周血清鞘脂Cer(d18∶1/8∶0)-1-P可能是乙肝相关AFP阴性HCC的潜在诊断标志物。更多还原

【Abstract】 Objective To explore the diagnostic value of serum sphingolipids for HBV-related AFP negative hepatocellular carcinoma(HCC). Methods Fifteen patients with HBV-related AFP negative HCC and 49 HBV-related liver cirrhotic patients were enrolled in this study. The expression levels of 61 serum sphingolipids were detected by highperformance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS). Results Among 61 kinds of sphingolipids,14 kinds of sphingolipids had significant differences between two groups(P < 0. 05). The results of OPLSDA analysis showed that Cer(d18∶ 1/8∶ 0)-1-P,Sphingosine(d17∶ 1)-1-P and Sphingosine(d18∶ 1)-1-P had the potential to differentiate HBV-related AFP negative HCC from cirrhosis,and their expression levels in HBV-related AFP negative HCC patients were 217. 74 pmol/0. 1 ml,58. 28 pmol/0. 1 ml and 62. 99 pmol/0. 1 ml,respectively,which were significantly higher than those in HBV-related cirrhosis(P < 0. 05). These 3 sphingolipids were further included in the Logistic regression analysis and the results showed that Cer(d18 ∶ 1/8 ∶ 0)-1-P was independently associated with HBVrelated AFP negative HCC(OR = 0. 667,95% CI: 0. 481-0. 923,P < 0. 05),and its sensitivity and specificity for predicting HBV-related AFP negative HCC were 81. 6%,86. 7%,respectively. Conclusion Up-regulation of Cer(d18∶ 1/8∶ 0)-1-P levels in serum may be used to identify HBV-related AFP-negative HCC.更多还原