外周血免疫炎症因子对肝细胞肝癌预后预测作用评价.docVIP

外周血免疫炎症因子对肝细胞肝癌预后预测作用评价 　　【摘要】目的探讨肝癌患者手术前后及确认复发时免疫炎症因子的表达及其临床意义，并监测其在复发中的价值。 　　方法检测2007年9月～2015年6月间201例肝部分切除肝癌患者手术前后及70例健康体检者肿瘤坏死因子α（TNFα）和高敏C反应蛋白（hsCRP）的水平，分析术前TNFα和hsCRP水平与临床病理特征的关系，并对手术后复发的102例肝癌患者的TNFα和hsCRP水平进行回顾性分析。同时检测可溶性E钙黏蛋白（sEC）和甲胎蛋白（AFP）进行对比分析。 　　结果肝细胞癌患者术前TNFα、hsCRP和sEC水平显著高于健康体检者，手术1周后TNFα、hsCRP和sEC水平较术前显著下降（P0.05）。当确诊为肝癌复发时，TNFα、hsCRP、AFP和sEC水平明显高于术后水平（P0.01），但TNFα、hsCRP术后再次升高的时间明显早于sEC。 　　结论术前肝细胞癌外周血免疫炎症因子TNFα、hsCRP 和sEC水平与临床分期有关，可作为一种肝细胞癌预后和复发的预测因子。TNFα更侧重于肝癌时机体全身状态，而hsCRP和sEC更侧重于癌组织局部生物学状态。 　　【关键词】肿瘤坏死因子α；高敏C反应蛋白；可溶性E钙黏蛋白；肝细胞癌；手术；复发 　　中图分类号：R735.7 文献标识码：ADOI：10.3969/j.issn2016.01.004 　　【Abstract】ObjectiveTo investigate expression of immune inflammatory factor and its clinical significance in patients with HCC （hepatocellular carcinoma） before and after operation， and at the time when they were confirmed for relapse. In addition， clinical significance of immune inflammatory factor in recurrence of HCC was monitored. 　　MethodsThe levels of tumor necrosis factorα（TNFα） and highsensitivity Creactive protein（hsCRP） in 201 HCC patients were tested by enzyme linked immunosorbent assay（ELISA） before and after operation as well as in 70 healthy controls from September， 2007 to June， 2015. And their correlation with clinical and pathological factors were analyzed. In addition， levels of TNFαand hsCRP of 102 patients who relapsed after operation were retrospectively analyzed. At the same time， serum soluble Ecadherin（sEC） and alphafetoprotein（AFP） were detected and compared. 　　Results The levels of TNFα， hsCRP and sEC in HCC patients before operation were significantly higher than those in the healthy controls， but they declined significantly one week after operation（P0.05）. When patients were confirmed with recurrence of HCC， their TNFα， hsCRP， AFP and sEC levels were significantly higher than those after operation（P0.01）， but TNFαand hsCRP levels raised more earlier than sEC level. 　　ConclusionThe levels of TNFα， hsCRP and sEC in HCC pat