血清巨噬细胞抑制因子-1在肝癌患者中的临床诊断价值

目的：初步探讨血清中巨噬细胞抑制因子-1（MIC-1）的浓度在肝癌患者中的临床应用价值。方法分别采用双抗体夹心ELISA法和电化学发光免疫分析仪检测271例未经治疗的肝癌患者，48例肝脏良性疾病患者，30例乙肝携带者及104例健康对照者的血清MIC-1浓度和血清甲胎蛋白（AFP）浓度。结果在肝癌患者中血清MIC-1浓度比较，男性患者高于女性患者，差异无统计学意义（P=0.255）；有病毒性肝炎史患者高于无病毒性肝炎史患者，差异有统计学意义（P=0.038）；MIC-1浓度随肝癌患者临床巴塞罗那分期（BCLC）进展而升高，差异有统计学意义（P﹤0.05）；不同分化程度组差异无统计学意义（P=0.146）；不同病理类型，肝细胞癌组高于胆管细胞癌组，差异有统计学意义（P=0.044）；MIC-1在早期肝癌患者（0期和A期）中显示出良好的诊断敏感度，优于AFP。肝癌患者组血清MIC-1浓度高于肝脏良性疾病组、乙肝携带者组及健康对照者；根据肝癌患者及健康对照者的受试者操作特性曲线（ROC）设定1.8 ng/ml作为MIC-1诊断肝癌的界值时，特异度和敏感度分别为96.2%和97.4%，高于AFP的96.2%和73.1%。结论本研究结果显示MIC-1可成为理想的癌筛查及诊断血清肿瘤标志物，在肝癌诊断特别是早期诊断方面显示出良好应用前景。

Clinical value of serum MIC-1 level in patients with liver cancer

Objective To study the clinical value of serum macrophages inhibitory cytokine-1 (MIC-1) in patients with liver cancer. Method Serum levels of MIC-1 and AFP in 271 patients with liver cancer were detected by double-an-tibody ELISA Kit and Roche Cobas 601 ECL analyzer, in which 48 cases were with benign liver disease, 30 were HBV carriers, and there were 104 healthy subjects. Results MIC-1 level in male patients was higher than that in females, with no significant differences observed (P=0.255); And patients with history of viral hepatitis had higher MIC-1 level than those without (P=0.037);MIC-1 level elevated as the clinical progression of BCLC increased (P<0.05);The MIC-1 levels in all subgroups of differentiation were similar (P=0.146);While in respect of pathological types, MIC-1 was significant-ly higher in hepatocellular carcinoma than in cholangiocarcinoma (P=0.044);It was demonstrated that MIC-1 was of su-perior sensitivity compared with AFP in diagnosing patients with liver cancer in early stage (stage 0 and A);When the cut-off value of MIC-1 was set at 1.8 ng/ml in ROC curve of liver cancer patients vs healthy subjects, the specificity and sensi-tivity of MIC-1 were 96.2%and 97.4%, and were better than AFP at 96.2%and 73.1%, respectively. Conclusion Our re-sults suggest that MIC-1 may be an ideal serum marker for screening and diagnosis of liver cancer, especially in the early stage.