血清肝细胞生长因子在慢性肝病中的意义

目的 肝细胞生长因子(HGF)能促进上皮细胞增生、运动、变形，是肝再生的起始因子之一，近来发现其在肝硬化和肝肿瘤的发生发展中也有重要作用。现主要探讨血清HGF水平在慢性肝病中的意义。方法 检测197例个体血清HGF水平，包括肝细胞癌(HCC)80例，肝硬化(LC)57例，慢性肝炎(CH)22例，正常对照38例。ELISA法检测血清HGF水平，并描绘受试者工作曲线(ROC)，确定HCC和LC患者HGF水平的最佳临界点。运用Spearman相关分析HGF水平和ALT、AST、GGT、白蛋白、总胆红索、凝血时间、肝癌大小、病理分级的相关性。结果 HCC、LC、CH和正常对照组的血清HGF中位值分别是6．767、151．200、7．017和3．476pg／m1。其中HCC组(P＜0．05)和比组(P＜0．01)的血清HGF水平显著高于正常对照组。LC组根据Child分级分层发现，Child C级患者的HGF水平明显高于Child A、B级。肝硬化ROC曲线显示，14pg／m1为临界值时效率最高。血清HGF水平仅发现与凝血时间有相关性(r=0．45，P＜0．01)。在HCC组中，未发现血清HGF水平与肿瘤大小、病理分级有任何相关。结论 血清中HGF水平增高与LC程度有关。

Role of hepatocyte growth factor in chronic liver diseases

Objective Hepatocyte growth factor (HGF) has been found to stimulate proliferation, mobility and morphological changes of epithelial cells and acts as one of the initiate factors in liver regeneration. Recently, it is found to play an important role in liver cirrhosis(LC) and liver tumorigenesis and development. We mainly discussed the significance of serum HGF in chronic liver diseases. Methods One hundred and Ninety-seven individuals including 80 hepatocellular carcinoma (HCC), 57 LC, 22 chronic hepatitis (CH) and 38 healthy people were tested. Serum HGF levels in HCC, LC and CH patients were each detected by ELISA. The HGF receiver operator characteristic (ROC) curves for LC and HCC patients were drawn to determine the perfect cut off point, respectively. The correlation between serum HGF level and other laboratory findings including ALT, AST, GGT, albumin, total bilirubin, prothrombin time, tumor size and tumor pathological grade was analyzed by Spearman analysis. Results The median serum HGF levels of patients of HCC, LC, CH and normal control were 6.767, 151.200, 7.017, and 3.476 pg/ml, respectively. Serum HGF levels of HCC (P<0.05) and LC (P<0.01) patients were significantly higher than those of healthy group. Patients of LC with Child C had higher HGF levels than those with Child A (P<0.01) or B (P< 0.05). In LC group, the ROC curve suggested that the perfect HGF cut off point should be set at 14 pg/ml to gain the best sensitivity and specificity. Serum HGF level was correlated with prothrombin time (r=0.45, P<0.01). In HCC group, no correlation was found between serum HGF and tumor size or tumor pathological grade. Conclusions Serum HGF expression level may be correlated with LC.