【作者】 侯振江； 王秀文； 张丽华； 周秀艳； 戴永路； 阎金辉；

【Author】 Hou Zhen-Jiang Wang Xiu-Wen Zhang Li-Hua et al Cang Zhou Medical College He Bei, 061001, China

【机构】 河北省沧州医学院高等专科学校； 沧州市中心医院； 唐山市人民医院；

【摘要】 目的:探讨PHC患者血清Lep、VEGF和AFP的表达和临床意义。方法:用ELISA检测30例健康对照、31 例肝硬化和146例PHC患者血清Lep、VEGF含量,分析Lep、 VEGF和AFP及其联合检测对PHC的诊断价值和临床分期及预后的关系。结果:PHC患者血清Lep水平与BMI高度相关,PHC患者血清Lep水平显著低于肝硬化组和健康对照组(P<0．05),女性均值高于男性1倍。随PHC TNM分期增加和转移、复发其血清Lep水平明显降低(P<0．05)。PHC 患者血清VEGF水平显著高于肝硬化组和健康对照组(P< 0．01),VEGF和AFP间无相关性,二者对PHC诊断的敏感性和特异性分别为(71．23％／73．29％)和(80．64％／83．87％), 联合检测可提高诊断的敏感性(91．81％)和准确度(90．40％)。 PHC患者VEGF水平与肿瘤大小呈正相关(P<0．01),Ⅲ、Ⅳ期患者血清VEGF水平也明显高于I、Ⅱ期患者(P<0．01),术后转移和复发患者血清VEGF水平明显升高(P<0．05)。结论: 血清Lep测定可判断PHC患者营养状况和预后,血清VEGF 与AFP联合测定可作为诊断PHC和判断其预后的重要指标。更多还原

【Abstract】 Objective: To explore the clinical significance and expression of serum leptin , VEGF and AFP in PHC. Methods: by using ELISA serum Lep , VEGF and AFP levels were determined in 146 patients with PHC, 31 patients with liver cirrhosis and 30 healthy control. The relationship among Lep, VEGF and AFP and clinical indexes were analyzed. Results: The serum Lep levels was significantly correlated to BMI in PHC group, and were significantly lower than those in liver cirrhosis group and in healthy control group (P<0.05)which showed 1 time higher in womem than in men. The serum Lep levels in PHC group were significantly lower with upgrade of TNM stage,transfer and recrudesce(P<0.05). The serum VEGFlevels in PHC group were significantly higher than those in liver cirrhosis group and in healthy control group(P<0.01)There no correlation between VEGF and AFP.VEGF and AFP diagnostic sensitivity is 71.23% and 73.29%, specificity is 80.64% and 83.87% in PHC.VEGF and AFP were determined their sensitivity is up to 91. 81%, accuracy is to 90.40%. There is no relationship beween VEGF and AFP. The levels of serum VEGF in the patients with PHC were strongly associated with tumor size(P<0.01).Serum VEGF showed a significant elevation in the patients with remote metastasis, recurrent PHC and TNM III, IV stages (P<0.01). Conclusion: It is suggested that the detection of serum VEGF and AFP might provide a significant index marker for PHC diagnosis and a predictor of prognosis更多还原