转化生长因子β1对原发性肝癌诊断价值的初步探讨

为了解转化生长因子β１（ＴＧＦβ１）在原发性肝癌中的诊断意义，用酶联免疫吸附试验法（ＥＬＩＳＡ）测定了４７例原发性肝癌（ＰＨＣ）、７７例其他各种肝病和消化道恶性肿瘤及２０例正常对照者的血清ＴＧＦβ１水平。结果：ＰＨＣ血清ＴＧＦβ１水平明显高于正常对照及其他各病组（Ｐ值分别＜０．０５或０．０１）。血清ＴＧＦβ１诊断ＰＨＣ的敏感性和特异性分别为７２．３％和７７．９％，甲胎蛋白（ＡＦＰ）阴性ＰＨＣ诊断阳性率为７８．６％，其中７例小肝癌有５例（７１．４％）血清ＴＧＦβ１阳性，与ＡＦＰ联合检测可提高ＰＨＣ诊断阳性率，达９３．６％。血清ＴＧＦβ１作为一种新的ＰＨＣ血清标志物应用于ＰＨＣ的诊断、监测和疗效判断，尤其是对ＡＦＰ阴性或早期肝癌的诊断，有重要临床意义。

Clinical evaluation of serum transforming growth factor beta 1 assay in the diagnosis of primary hepatic carcinoma]

Serum transforming growth factor beta 1 (TGF beta 1) concentration was determined in 47 patients with primary hepatic carcinoma (PHC) and 77 patients with various liver diseases and gastrointestinal tumors by means of enzyme-linked immunosorbent assay system. The result revealed that serum TGF beta 1 level of PHC patients were significantly higher (257.6 +/- 126.0 micrograms/L) than those in normal subjects (81.5 +/- 43.5 micrograms/L), in patients with hepatitis (152.4 +/- 98.4 micrograms/L), cirrhosis (191.8 +/- 96.3 micrograms/L), hepatic benign tumor (91.9 +/- 37.9 micrograms/L), metastatic liver cancer (146.4 +/- 73.7 micrograms/L) and gastrointestinal tumor (128.7 +/- 56.4 micrograms/L) (P < 0.01 or 0.05). Serum TGF beta 1 level was elevated in 34 of 47 (72.3%) PHC patients, including 5 of 7 (91.4%) small (< 5 cm) PHC patients. The sensitivity and specificity of diagnosis of TGF beta 1 in PHC were 72.3% and 77.9%, respectively. The diagnostic positivity was 78.5% in AFP-negative PHC patients. The combined assay of serum TGF beta 1 and AFP could further raise the detection rate of PHC up to 93.6%. Above results suggest that serum TGF beta 1 might be a candidate for a novel tumor marker for diagnosis and monitoring of PHC.