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目的探讨乙型肝炎病毒相关肝癌患者血清白介素28B(IL-28B)表达及意义。方法收集92例血清[包括慢性乙肝26例,乙肝肝硬化22例,原发性肝癌(PHC)34例,健康对照10例],采用酶联免疫吸附(ELISA)法检测IL-28B水平,将其与临床参数之间进行相关性分析、并行诊断性试验以确证IL-28B在肝癌诊断中的价值。结果①PHC组血清IL-28B水平显著高于慢乙肝、肝硬化及对照组(P<0.01),且与转氨酶、HBV-DNA之间无明确相关性(P>0.05);肿瘤数目<3的患者的IL-28B水平高于肿瘤数目≥3的患者(P<0.05)。②IL-28B诊断PHC的ROC曲线下面积为0.883,最佳截取值为611.0 pg/mL,此时的敏感度82.4%,特异度93.1%,而联合甲胎蛋白(AFP)诊断PHC的敏感度提高到88.2%,特异度为82.4%。结论 PHC的血清IL-28B的表达水平显著升高,且与肿瘤数目及大小之间存在一定相关性,提示其可能与肝癌发生密切相关。IL-28B与AFP联合检测可提高PHC诊断正确率,有望成为肝癌筛查的有用指标之一。
Objective To investigate the expression of interleukin 28 (IL-28B) in patients with hepatocellular carcinoma associated with hepatitis B virus (HBV) and its significance. Methods 92 cases of serum (including 26 cases of chronic hepatitis B, 22 cases of hepatitis B cirrhosis, 34 cases of primary liver cancer (PHC) and 10 cases of healthy controls] were collected. The level of IL-28B was measured by enzyme linked immunosorbent assay (ELISA) Its correlation with clinical parameters, parallel diagnostic tests to confirm the value of IL-28B in the diagnosis of liver cancer. Results ① The level of serum IL-28B in PHC group was significantly higher than that of chronic hepatitis B, cirrhosis and control group (P <0.01), and there was no significant correlation between serum IL-28B and aminotransferase and HBV-DNA (P> 0.05) The level of IL-28B was higher than the number of tumors ≥3 (P <0.05). The area under the ROC curve of IL-28B was 0.883, the optimal cut-off was 611.0 pg / mL, the sensitivity and the specificity were 82.4% and 93.1%, respectively, while the sensitivity of combined alpha-fetoprotein (AFP) To 88.2% with a specificity of 82.4%. Conclusion The serum level of IL-28B in PHC is significantly increased, and there is a certain correlation between the number and size of the tumor, suggesting that it may be closely related to the occurrence of liver cancer. Combined detection of IL-28B and AFP can improve the diagnostic accuracy of PHC and is expected to be one of the useful indicators of liver cancer screening.