血清DcR3检测在肝细胞癌中的诊断及预后评估价值

目的:探讨血清诱骗受体3(decoy receptor3,DcR3)对肝细胞癌(hepatocellular carcinoma,HCC)的临床诊断及预后评估的价值。方法:选取2016年1月至2017年12月首都医科大学附属北京同仁医院收治的120例HCC患者作为HCC组,取同期肝脏良性肿瘤患者作为对照组,比较各组血清DcR3水平,以及其与肿瘤分期、预后的关系,采用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清DcR3的HCC诊断效能。分析DcR3联合甲胎蛋白(alpha-fetoprotein,AFP)对HCC诊断的灵敏度及特异度。结果:HCC组血清DcR3水平高于对照组,术后其水平逐渐下降;随着肿瘤进展,血清DcR3表达水平逐渐升高。ROC曲线分析发现血清DcR3检测的ROC曲线下面积0.95,DCR3联合AFP检测的阳性率87.5%,大于二者单独检测的阳性率。血清DcR3高表达患者预后较差。结论:血清DcR3检测对HCC具有较高的诊断及预后判断价值;联合检测血清AFP、DcR3可提高诊断HCC的灵敏度。

The value of serum decoy receptor 3 in diagnosis and prognosis evaluation of hepatocellular carcinoma

Objective:To investigate the value of serum DcR3 in diagnosis and prognostic evaluation of hepatocellular carcinoma(HCC).Methods:120 patients with HCC admitted to Beijing Tongren Hospital during January 2016 and December 2017 were selected as the HCC group,and contemporaneous patients with benign liver disease were selected as the control group.ELISA was adopted to detect the levels of serum DcR3.The levels of serum DcR3 in each group were compared,and their relationships with tumor staging and prognosis were analyzed.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of serum DcR3 for HCC.The sensitivity and specificity values of serum DcR3+AFP in diagnosis of HCC were calculated.Result:The level of serum DcR3 in the HCC group was higher than that in the control group,and decreased gradually after hepatectomy.As HCC progresses,the level of serum DcR3 gradually increased.ROC curve analysis showed that the area under the ROC curve of DcR3 was 0.95.The positive rate of the combined DcR3+AFP test was 87.5%,which was higher than that of the two indicator alone.The prognosis of patients in the high-expression group of serum DcR3 was worse.Conclusion:Serum DcR3 detection has high diagnostic and prognostic value for HCC.Combined detection of serum AFP and DcR3 can improve the positive diagnosis rate of HCC.