肝癌发生相关细胞因子及脂质结合唾液酸检测与诊断价值的临床评价

目的探讨外周血血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）、游离胰岛素样生长因子-Ⅱ（FIGF-Ⅱ）和脂质结合唾液酸（LSA）浓度分析对肝癌诊断与鉴别的临床价值。方法以不同的定量方法，分别检测了肝癌、慢性肝炎和肝硬化患者外周血VEGF、TNF-α、FIGF-Ⅱ和LSA浓度，综合比较评价了多项指标对肝癌诊断与鉴别的临床意义。结果肝癌组患者外周血VEGF、FIGF-Ⅱ、LSA和TNF-α水平显著高于慢性肝炎组和肝硬化组（P〈0．05，P〈0．01），其阳性率分别为87．8％、75．6％、67．8％和86．7％。然而，未见良性肝病组间存在明显差异。综合评价多指标对肝癌诊断的敏感性、特异性和准确度，VEGF较好，分别为87．8％、87．2％和87．5％；TNF-α次之，分别为86．7％、65．4％和76．8％。结论肝癌发生相关细胞因子浓度分析有助于肝癌诊断及预后观察。

Clinical evaluation of hepatoma-related cytokines and LSA detection and their diagnostic values for hepatocellular carcinoma

Objective To investigate the clinical values of serum hepatoma-related cytokines （VEGF,TNF-α and FIGF-Ⅱ ） and lipid associated sialic acid （LSA） in diagnostic and differential values of hepatocellular carcinoma （ HCC ）. Methods The levels of VEGF, TNF-α, FIGF-Ⅱ , and LSA were quantitated in patients with HCC or with chronic liver diseases or with extrahepatic tumors. The clinical values of four markers for HCC patients were analyzed in this study. Results The levels of serum VEGF, FIGF- Ⅱ, LSA and TNF-α in HCC patients were significantly higher than those in patients with chronic liver diseases or with liver cirrhosis （ P 〈 0. 05 ）, and the incidence was 87. 8% in VEGF, 75.6% in TNF-α, 67.8% in LSA, and 86. 7% in FIGF-Ⅱ for HCC diagnosis, respectively. However, no significant different was found between chronic hepatitis group and liver cirrhosis group. The positive rates of LSA and TNF-α in HCC group were 67. 8% and 86. 7%, respectively. Comprehensive analysis of four markers in clinical application indicated that both of VEGF and TNF-α are useful markers for HCC with better sensitivity （87. 8% and 86. 7% ）, specificity （ 87.2% and 65.4% ）, and accuracy （ 87.5% and 76. 8% ） for HCC diagnosis, respectively. Conclusions The quantitative analysis of circulating VEGF, FIGF-Ⅱ, LSA, and TNF-α levels are helpful to diagnosis and differentiation of HCC.