摘要
目的:探讨血清Dickkopf-1(DKK-1)蛋白检测对早期肝细胞癌的诊断价值。方法:用酶联免疫吸附试验检测186例早期肝癌患者,196例中晚期肝癌患者,96例慢性肝炎、肝硬化患者,50例其他部位恶性肿瘤(肺癌、食管癌、乳腺癌等)患者,92例健康对照者血清中DKK-1含量,观察其含量变化;同时检测标本甲胎蛋白(alpha fetoprotein,AFP)含量,将DKK-1与AFP进行对比分析。结果:各组间AFP水平比较差异具有统计学意义(F=1 044,P=0.000),两两比较结果显示,中晚期肝癌组、早期肝癌组、慢性乙肝及肝硬化组与健康对照组比较AFP水平均升高(P<0.05);各组间DKK-1水平比较差异具有统计学意义(F=62.46,P=0.000),两两比较结果显示,早期肝癌组、中晚期肝癌组、其他系统癌组与健康对照组比较DKK-1水平均升高(P<0.05);以AFP<20 ng/m L为正常参考值,以AFP>400 ng/m L作为诊断肝癌的标准;以DKK-1<2.5 ng/m L为正常参考值,以DKK-1>4 ng/m L作为诊断肝癌的标准,计算各组阳性率,结果显示,AFP(86.2%)与DKK-1(73.5%)比较对中晚期肝癌的诊断率高(χ~2=9.91,P=0.007),但对早期肝癌诊断率AFP(20.4%)低于DKK-1(73.7%)(χ~2=105.76,P=0.000);在对其他系统癌的诊断中,AFP无阳性病例,而DKK-1(70.0%)增高(χ~2=53.85,P=0.000),故DKK-1对肝癌的诊断存在一定程度的假阳性率。结论:血清DKK-1蛋白测定可以作为肿瘤标志物用于肝细胞癌的血清诊断,与AFP联合应用可以提高早期肝癌的检出率。
Objective： To study the value of serum Dickkopf - 1 （ DKK - 1 ） protein in the diagnosis of earl.,,, hepatocellular carcinoma. Methods： Enzyme - linked immunosorbent assay （ELISA） was adopted to detect the serum levels of DKK - 1 in 186 cases of patients with early hepatocellular carcinoma, 196 patients with middle - late stage of liver cancer, 96 cases of chronic hepatitis and cirrhosis, 50 cases of other cancer patients （ such as lung cancer, esophageal cancer, breast cancer, elc）, and 92 cases of healthy controls, and the changes were observed and compared. The alpha fetoprotein （AFP） levels were also detected and the data of DKK - 1 and AFP were analyzed and compared. Results： Theru was statistically significant difference of AFP level between the groups （ F = 1044, P =0. 000）. AFP level increased significantly in middle -late stage liver cancer group, in early hepatocellalar carcinoma group and in chronic hepatitis and cirrhosis group com- pared with that in healthy control group （ P 〈 0.05 ） ; There was statistically significant difference of DKK - 1 level between the groups （ F = 62.46, P = 0. 000 ）. Compared with that in healthy control group, the level of DKK - 1 increased significantly in early hepatocellular carcinoma group, in middle - late stage liver cancer group and in other cancer .group （ P 〈0.05）. AFP 〈 20 ng/mL was used as the normal reference value and AFP 〉 400 ng/mL was used as the diagnosis standard of liver cancer. DKK - 1 〈 2.5 ng/mL was used as the normal reference value and DKK - 1 〉 4 ng / mL was used as the diagnosis standard of liver cancer. Positive diagnosis rate was calculated according to the standard. The positive diagnosis rate of AFP （ 86.2 % ） was higher compared with that of DKK - 1 （73.5 % ） in middle - late stage liver cancer group （ X^2 = 9.91, P = 0.007）. The diagnostic rate of AFP （20.4 % ） was lower than that of DKK - 1 （73.7 % ） in early hepatoeellular carcinoma group （X^2 = 105.76, P = 0. 000）. In the diagnosis of other cancer patients, AFP had no positive cases, while DKK - 1 increased （70.0 % ） （X2 = 53. 85. P = 0. 000）. So DKK - 1 on the diagnosis of liver cancer had a certain degree of false positive rate. Conclusion： The determination of serum DKK - 1 protein can be used as a tumor marker in the diagnosis of hepatocellular carcinoma （ HCC）, and the joint application with APF can improve the detection rate of early hepatocellu- lar carcinoma .
作者
宗来斌
张凤丽
陈慧
张英杰
ZONG Laibin ZHANG Fengli CHEN Hui ZHANG Yingjie(Laboratory Department of Bengbu Medical College, Bengbu 233030, Chin)
出处
《包头医学院学报》
CAS
2017年第6期4-5,14,共3页
Journal of Baotou Medical College
基金
2014年国家大学生创新创业项目(11210210149)
