肝癌及肝硬化患者可溶性endoglin的临床意义*

目的：本研究拟探讨肝癌及肝硬化患者血清中可溶性endoglin 的表达及其临床意义。方法：采用酶联免疫吸附实验（ELISA）方法检测87例肝癌患者、30例肝硬化患者及28例健康对照组血清endoglin 的浓度，分析肝癌患者血清endoglin 表达与肝癌分期、门脉癌栓及远处转移等临床指标的关系。结果：肝癌合并肝硬化患者血清endoglin 浓度显著高于肝硬化组（P<0.001）及正常对照组（P<0.001），肝硬化患者血清endoglin 浓度显著高于正常对照组（P=0.016）。 进一步研究发现，肿瘤最大径>5cm，有远处转移，有门脉癌栓、AFP>400ng/mL、肝癌临床分期Ⅲ期的患者血清endoglin 的浓度均明显升高（P<0.05），ROC 分析发现endoglin和AFP 联合检测后敏感性提高，曲线下面积较前增加。结论：我们在国内首次阐明可溶性endoglin 在肝癌及肝硬化患者中的临床意义，血清endoglin 可作为评估乙肝肝硬化进展为肝癌的补充诊断指标，可能有一定早期诊断、预测复发转移及预测预后的价值。

The Expression of Soluble Endoglin in Patients with Liver Cirrhosis and Hepatocellular Carcinoma and Its Clinical Significance

Objective:To investigate the expression of soluble endoglin in patients with liver cirrhosis and hepatocellu -lar carcinoma (HCC) and to determine its clinical significance. Methods:We used Enzyme-Linked Immunosorbent Assay (ELISA) to measure the serum concentration of soluble endoglin in 87HCC patients,30hepatic cirrhosis patients and28 healthy controls. We also collected the clinical data of all of these patients and analyzed the relationship between soluble endoglin serum level and tumor stage, portal vein thrombus, and distant metastasis. Results: The serum concentration of soluble endoglin in patients with HCC and hepatic cirrhosis was significantly higher than that in patients with hepatic cirrho-sis ( P<0.001 ) and the control group (P<0.001 ). The serum concentration of soluble endoglin in the hepatic cirrhosis group was significantly higher than that in the control group (P=0.016 ). The serum concentration of soluble endoglin was highest in HCC patients with a tumor mass larger than 5 cm, distant metastasis, portal vein thrombus, an AFP level higher than400 ng/mL and at a later clinical stage. ROC analysis showed that combined tes for endoglin and AFP levels has higher sensitiv-ity than assessing either alone, and the AUC was increased. Conclusion:Soluble endoglin has the potential to be a novel complementary biomarker in the risk assessment for development of HCC in cirrhotic patients and can be used as an early diagnostic index. Soluble endoglin can be used as a marker for the recurrence, metastasis and prognosis of HCC.