原发性肝癌患者血清sTRAIL、MMP-3水平及其与肝纤维化指标的相关性

目的分析原发性肝癌患者血清可溶性肿瘤细胞坏死因子相关凋亡诱导配体(sTRAIL)、基质金属蛋白酶-3(MMP-3)水平,以及其与肝纤维化指标的相关性。方法 52例原发性肝癌患者纳入原发性肝癌组,63例良性肿瘤患者纳入良性肿瘤组,39例健康体检者纳入对照组,比较各组血清sTRAIL、MMP-3及肝纤维化指标水平,并分析血清sTRAIL、MMP-3及肝纤维化指标透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)]的相关性,绘制受试者工作特征(ROC)曲线分析血清sTRAIL、MMP-3水平对原发性肝癌的诊断价值。结果原发性肝癌组血清sTRAIL、MMP-3水平高于良性肿瘤组及对照组,良性肿瘤组血清sTRAIL、MMP-3水平高于对照组,原发性肝癌组HA、LN、PCⅢ、Ⅳ-C水平高于良性肿瘤组及对照组,差异均有统计学意义(P<0.05);良性肿瘤组与对照组的HA、LN、PCⅢ、Ⅳ-C水平比较,差异无统计学意义(P>0.05)。TNM分期Ⅰ期、Ⅱ期、Ⅲ期患者血清sTRAIL、MMP-3、HA、LN、PCⅢ、Ⅳ-C水平依次升高,两两比较,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,sTRAIL、MMP-3、sTRAIL+MMP-3的ROC曲线下面积分别为0.686、0.730、0.806。相关分析显示,原发性肝癌患者血清sTRAIL、MMP-3与HA、LN、PCⅢ、Ⅳ-C之间均呈正相关(r=0.501~0.651,P<0.05)。结论血清sTRAIL、MMP-3可能参与原发性肝癌的发生、发展,且与肝纤维化指标呈正相关,对原发性肝癌的早期诊断有重要价值。

Expression levels of serum sTRAIL and MMP-3 in patients with primary liver cancer and their correlation with liver fibrosis indexes

Objective To analyze the levels of serum soluble tumor cell necrosis factor-associated apoptosis-inducing ligand(sTRAIL)and matrix metalloproteinase-3(MMP-3)in the patients with primary liver cancer and their correlation with liver fibrosis indexes.Methods Fifty-two patients with primary liver cancer were included into the primary liver cancer group,63 patients with benign tumors were included into the benign tumor group,and 39 subjects undergoing healthy physical examination were included into the control group.The levels of serum sTRAIL,MMP-3 and liver fibrosis indexes were compared among the groups,and the correlations among serum sTRAIL,MMP-3 and indicators of liver fibrosishyaluronic acid(HA),laminin(LN),typeⅢprocollagen peptide(PCⅢ),typeⅣcollagen(Ⅳ-C)]were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of sTRAIL and MMP-3 level in primary liver cancer.Results The levels of serum sTRAIL and MMP-3 in the pimary liver cancer group were higher than those in the benign tumor group and control group,the levels of serum sTRAIL and MMP-3 in the benign tumor group were higher than those in the control group,the levels of HA,LN,PCⅢandⅣ-C in the pimary liver cancer group were higher than those in the benign tumor group and control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of HA,LN,PCⅢandⅣ-C between the benign tumor group and control group(P>0.05).The levels of serum sTRAIL,MMP-3,HA,LN,PCⅢ,Ⅳ-C in the patients with TNM stageⅠ,Ⅱ,Ⅲof primary liver cancer were increased in turn,and the pairwise comparison showed statistically significant differences(P<0.05).The area under the ROC curve(AUC)analysis results showed that the AUC of TRAIL,MMP-3,TRAIL+MMP-3 were 0.686,0.730 and 0.806 respectively.The correlation analysis showed that serum sTRAIL and MMP-3 showed the positive correlation with HA,LN,PCⅢandⅣ-C in the patients with primary liver cancer(r=0.501-0.651,P<0.05).Conclusion Serum sTRAIL and MMP-3 might be involved in the occurrence and development of primary liver cancer,moreover are positively correlated with the liver fibrosis indexes,which has a great value for early diagnosis of primary liver cancer.