肝纤维化血清学指标水平与肝癌的相关性研究

目的 研究血清Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白和透明质酸在肝癌诊断中的价值.方法 采用放射免疫法测定52例原发性肝癌、34例转移性肝癌、34例肝外恶性肿瘤患者及100例健康体检人员血清Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白和透明质酸水平,并进行分析比较.结果 治疗前和治疗1、3个月后,原发性肝癌组Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白、血清透明质酸水平(计量单位为μg/L)分别为(176±43)、(166±38)、(129±38);(139±34)、(108±31)、(85±32);(123±23)、(100±23)、(93±18);(347±136)、(299±120)、(266±113)μg/L,转移性肝癌组分别为(97±25)、(93±22)、(79±16);(96±31)、(80±28)、(77±19);(93±24)、(80±21)、(62±15);(254±108)、(199±98)、(132±93)μg/L.原发性肝癌组血清透明质酸和Ⅳ型胶原水平在治疗前与对照组[(67±11)、(55±15)μg/L]比较差异均有统计学意义(均P＜0.01),Ⅲ型前胶原和层粘连蛋白水平明显高于对照组[(55±11)、(54±13)μg/L,P＜0.05)].转移性肝癌组及肝外恶性肿瘤组治疗前透明质酸[(149±68)μg/L]与对照组比较,差异均有统计学意义(均P＜0.05).原发性肝癌组治疗前后血清Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白和透明质酸水平均明显高于同一时间转移性肝癌组的水平(均P＜0.05).原发性肝癌组各项指标治疗前和治疗1、3个月后之间相比均差异有统计学意义(均P＜0.05).结论 血清Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白和透明质酸水平与原发性肝癌具有相关性,可作为反映原发性肝癌严重程度和预后的指标.

Abstract：

Objective To investigate the significance of serum fibrosis markers in liver fibrosis in liver neoplasms. Methods Radioimmunoassay was used to measure the level of serum procollagen (PC) Ⅲ, collagen type Ⅳ(Ⅳ-C), laminin LN and hyaluronic acid(HA) in 120 patients with liver neoplasms and 100 healthy people.Results Before therapy, the level of Ⅳ-C in the hepatocellular carcinoma group showed significant difference compared with those in control group (P＜0. 01 ). The levels of PCⅢ and LN in the hepatocellular carcinoma group were higher than those in control group ( P ＜ 0.05 ). Before therapy the levels of HA in metastatic cancer of liver group and extrahepatic malignant tumor group were higher than those in control group ( P ＜ 0. 05 ). Before and after the therapy the levels of hepatocellular carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly higher than those in the metastatic cancer of liver group ( P ＜ 0. 05). Before and after the therapy the levels of hepatocellula carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly difference ( P ＜ 0.05 ). Conclusions The levels of serum PC Ⅲ, Ⅳ-C, LN and HA are significantly related with the hepatocellular carcinoma. These markers can reflect the fibrosis degree of chronic hepatocellular carcinoma and will be an indicator of prognosis.

Relevance between the measurement of serum fibrosis markers and hepatic carcinoma

Objective To investigate the significance of serum fibrosis markers in liver fibrosis in liver neoplasms. Methods Radioimmunoassay was used to measure the level of serum procollagen (PC) Ⅲ, collagen type Ⅳ(Ⅳ-C), laminin LN and hyaluronic acid(HA) in 120 patients with liver neoplasms and 100 healthy people.Results Before therapy, the level of Ⅳ-C in the hepatocellular carcinoma group showed significant difference compared with those in control group (P＜0. 01 ). The levels of PCⅢ and LN in the hepatocellular carcinoma group were higher than those in control group ( P ＜ 0.05 ). Before therapy the levels of HA in metastatic cancer of liver group and extrahepatic malignant tumor group were higher than those in control group ( P ＜ 0. 05 ). Before and after the therapy the levels of hepatocellular carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly higher than those in the metastatic cancer of liver group ( P ＜ 0. 05). Before and after the therapy the levels of hepatocellula carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly difference ( P ＜ 0.05 ). Conclusions The levels of serum PC Ⅲ, Ⅳ-C, LN and HA are significantly related with the hepatocellular carcinoma. These markers can reflect the fibrosis degree of chronic hepatocellular carcinoma and will be an indicator of prognosis.