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目的初步探讨血清中巨噬细胞抑制因子-1(MIC-1)的浓度在肝癌患者中的临床应用价值。方法分别采用双抗体夹心ELISA法和电化学发光免疫分析仪检测271例未经治疗的肝癌患者,48例肝脏良性疾病患者,30例乙肝携带者及104例健康对照者的血清MIC-1浓度和血清甲胎蛋白(AFP)浓度。结果在肝癌患者中血清MIC-1浓度比较,男性患者高于女性患者,差异无统计学意义(P=0.255);有病毒性肝炎史患者高于无病毒性肝炎史患者,差异有统计学意义(P=0.038);MIC-1浓度随肝癌患者临床巴塞罗那分期(BCLC)进展而升高,差异有统计学意义(P﹤0.05);不同分化程度组差异无统计学意义(P=0.146);不同病理类型,肝细胞癌组高于胆管细胞癌组,差异有统计学意义(P=0.044);MIC-1在早期肝癌患者(0期和A期)中显示出良好的诊断敏感度,优于AFP。肝癌患者组血清MIC-1浓度高于肝脏良性疾病组、乙肝携带者组及健康对照者;根据肝癌患者及健康对照者的受试者操作特性曲线(ROC)设定1.8 ng/ml作为MIC-1诊断肝癌的界值时,特异度和敏感度分别为96.2%和97.4%,高于AFP的96.2%和73.1%。结论本研究结果显示MIC-1可成为理想的癌筛查及诊断血清肿瘤标志物,在肝癌诊断特别是早期诊断方面显示出良好应用前景。
Objective To investigate the clinical value of serum concentration of macrophage inhibitory factor-1 (MIC-1) in patients with liver cancer. Methods Serum MIC-1 concentrations in 271 patients with untreated liver cancer, 48 patients with benign liver disease, 30 hepatitis B carriers and 104 healthy controls were measured by sandwich ELISA and chemiluminescence immunoassay. Serum alpha-fetoprotein (AFP) concentration. Results There was no significant difference in the serum concentrations of MIC-1 between the male patients and the female patients (P = 0.255). The patients with history of viral hepatitis were higher than those without the history of viral hepatitis, the difference was statistically significant (P = 0.038). The concentration of MIC-1 increased with the progress of BCLC in patients with hepatocellular carcinoma (P <0.05). There was no significant difference in different degree of differentiation (P = 0.146) The expression of MIC-1 showed a good diagnostic sensitivity in patients with early-stage liver cancer (stage 0 and stage A), which was significantly higher than that of cholangiocarcinoma in different pathological types (P = 0.044) At AFP. The concentration of serum MIC-1 in patients with liver cancer was higher than that in patients with benign liver disease, HBV carriers and healthy controls. According to the receiver operating characteristic curve (ROC) of liver cancer patients and healthy controls, 1.8 ng / ml was set as MIC- 1 diagnosis of liver cancer threshold, the specificity and sensitivity were 96.2% and 97.4%, higher than 96.2% and 73.1% of AFP. Conclusion The results of this study show that MIC-1 can be an ideal marker for cancer screening and diagnosis of serum tumor, showing good application prospect in the diagnosis of liver cancer, especially in the early diagnosis.