目的: 探讨血清甲胎蛋白（alpha-fetoprotein,AFP）、趋化因子配体10（chemokine ligand 10,CXCL10）-mRNA、巯基氧化酶1（quiescin sulfhydryl oxidase 1,QSOX1）-mRNA的检测在乙肝病毒相关肝细胞肝癌（hepatocellular carcinoma,HCC）诊断中的临床应用价值。方法: 选取2022年1月—2023年5月长沙市第一医院感染科住院患者及体检中心健康人群共120例为研究对象,其中包括50例乙肝相关早期HCC患者（肝细胞癌组）、40例肝硬化组以及30例正常对照组;采用RT-PCR方法检测外周血CXCL10-mRNA、QSOX1-mRNA表达,放射免疫法检测AFP水平;比较3 组血清CXCL10-mRNA、QSOX1-mRNA、AFP水平差异,并绘制受试者工作曲线,分析CXCL10-mRNA、QSOX1-mRNA、AFP 指标检测在HBV相关HCC早期诊断效能。结果: 肝细胞癌组患者外周血中检测到AFP的阳性率高于肝硬化组,差异有统计学意义;肝细胞癌组患者CXCL10-mRNA、QSOX1-mRNA、AFP表达水平均高于肝硬化组及健康对照组;肝硬化组血清CXCL10-mRNA、QSOX1-mRNA水平显著高于对照组;采用ROC曲线分析显示,CXCL10-mRNA、QSOX1-mRNA、AFP指标检测诊断早期HBV-HCC的AUC 分别为0.881,0.790、0.814;三个指标联合检测AUC为0.957,诊断HCC的敏感度和特异度分别达到0.860和0.971,高于3种标志物单独检测的敏感度和特异度,诊断效能高于单一检测。结论: CXCL10-mRNA、QSOX1-mRNA水平在HBV相关HCC及肝硬化患者血清中呈高表达,两者与AFP联合检测能够提升乙肝相关性HCC的早期诊断效率。
Abstract
Objective To explore the clinical application value of serum alpha-fetoprotein (AFP), CXCL10-mRNA, and QSOX1-mRNA detection in the diagnosis of hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC). Methods A total of 120 subjects were selected from hospitalized patients in the Department of Infectious Diseases and healthy individuals from the physical examination center at The First Hospital of Changsha from January 2022 to May 2023. The subjects included 50 patients with early HBV-related HCC, 40 patients with liver cirrhosis, and 30 healthy individuals. The expression levels of peripheral blood CXCL10-mRNA and QSOX1-mRNA were detected by RT-PCR, and the AFP level was measured using a radioimmunoassay. The differences in serum levels of CXCL10-mRNA, QSOX1-mRNA, and AFP among the three groups were compared. Receiver operating characteristic (ROC) curves were plotted, and the diagnostic value of CXCL10-mRNA, QSOX1-mRNA, and AFP markers in the early diagnosis of HBV-related HCC was analyzed. Results The positive rate of AFP detection in the peripheral blood of the hepatocellular carcinoma (HCC) group patients was higher than that in the liver cirrhosis group, and the difference was statistically significant (P<0.05). The expression levels of CXCL10-mRNA, QSOX1-mRNA, and AFP in the HCC group were higher than those in the liver cirrhosis group and the healthy control group (P<0.05). The serum levels of CXCL10-mRNA and QSOX1-mRNA in the liver cirrhosis group were significantly higher than those in the healthy control group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for CXCL10-mRNA, QSOX1-mRNA, and AFP in the early diagnosis of HBV-related HCC was 0.881, 0.790, and 0.814 respectively. The AUC for the combined detection of the three markers was 0.957, with a sensitivity and specificity for diagnosing HCC of 0.860 and 0.971, respectively, which were higher than those for the individual markers, indicating higher diagnostic performance. Conclusion The levels of CXCL10-mRNA and QSOX1-mRNA are highly expressed in the serum of patients with HBV-related HCC and cirrhosis. Combined detection of these markers with AFP can improve the early diagnostic efficiency of HBV-related HCC.
关键词
趋化因子配体10 /
巯基氧化酶1 /
甲胎蛋白 /
HBV相关肝细胞癌
Key words
chemokine ligand 10 /
quiescin sulfhydryl oxidase 1 /
alpha-fetoprotein /
hepatitis B virus-related hepatocellular carcinoma
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基金
2022年湖南省卫生健康委科研计划项目“血清CXCL10、QSOX1联合AFP对HBV相关肝细胞癌早期诊断的临床研究”（202203082996）
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