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目的探讨血清甲胎蛋白(alpha-fetoprotein,AFP)、Dickkopf-1(DKK1)和白细胞介素-6(interleukin-6,IL-6)在肝细胞癌(hepatocellular carcinoma,HCC)诊断中的价值。方法 HCC患者60例为肝癌组,乙型病毒性肝炎患者40例为肝炎组,肝硬化患者40例为肝硬化组,体检健康者40例为正常对照组;采用ELIAS方法检测各组血清中AFP、DKK1和IL-6水平,并进行比较;分析HCC患者临床病理参数与AFP、DKK1和IL-6水平的关系;绘制ROC曲线,观察AFP、DKK1和IL-6对HCC的诊断效能。结果肝癌组血清AFP和DKK1水平[(447.00±329.60)、(3.167±1.431)μg/L]高于肝硬化组[(27.69±16.54)、(1.164±0.472)μg/L)、肝炎组[(34.87±34.19)、(1.320±0.529)μg/L]和正常对照组[(6.08±4.24)、(1.099±0.369)μg/L](P<0.05),血清IL-6水平[(43.78±35.42)ng/L]高于肝硬化组[(18.59±16.73)ng/L]和正常对照组[(19.91±5.98)ng/L],与肝炎组[(36.71±29.04)ng/L]比较差异无统计学意义(P>0.05);HCC患者AFP、DKK1和IL-6水平在不同肿瘤大小、数目和分化程度中差异无统计学意义(P>0.05),但Child Pugh B~C级患者AFP和IL-6水平[(648.00±452.30)μg/L、(70.72±59.06)ng/L]明显高于Child-Pugh A级患者[(318.60±296.70)μg/L、(38.02±29.59)ng/L],差异有统计学意义(P<0.05);ROC曲线显示,AFP、DKK1和IL-6对HCC检测灵敏度分别为86.5%、80.2%和76.5%,特异性分别为70.7%、90.3%和65.9%;三者联合检测HCC的灵敏度和特异性分别为90.3%和89.8%。结论 DKK1和IL-6可作为HCC诊断的潜在血清标志物,与AFP联合可提高检测效率。
Objective To investigate the value of serum alpha-fetoprotein (AFP), Dickkopf-1 (DKK1) and interleukin-6 (IL-6) in the diagnosis of hepatocellular carcinoma (HCC) Methods Forty patients with hepatocellular carcinoma (HCC), 40 patients with hepatitis B virus (HBV), 40 patients with hepatocirrhosis (cirrhosis) and 40 healthy controls were normal controls. ELIAS was used to detect serum AFP , DKK1 and IL-6 were measured and compared. The relationship between clinicopathological parameters and the levels of AFP, DKK1 and IL-6 in HCC patients was analyzed. The ROC curve was drawn to observe the diagnostic efficacy of AFP, DKK1 and IL-6 in HCC. Results The levels of serum AFP and DKK1 in hepatocellular carcinoma group were significantly higher than those in cirrhotic group [(447.00 ± 329.60) vs (3.167 ± 1.431) μg / L vs (1.66 ± 0.472) μg / L vs (P <0.05). The level of IL-6 in the serum was significantly higher than that in the control group [(34.87 ± 34.19), (1.320 ± 0.529) μg / L] and the normal control group (6.08 ± 4.24, 1.099 ± 0.369 μg / L, ) was significantly higher than that in cirrhosis group (18.59 ± 16.73 ng / L) and normal control group (19.91 ± 5.98) ng / L, and (36.71 ± 29.04) ng / L in hepatitis group (P> 0.05). The levels of AFP, DKK1 and IL-6 in HCC patients were not statistically different between different tumor size, number and differentiation (P> 0.05) , And IL-6 levels (648.00 ± 452.30 μg / L, (70.72 ± 59.06) ng / L] were significantly higher than those in Child-Pugh class A patients (318.60 ± 296.70 μg / L and 38.02 ± 29.59 ng / The sensitivity of AFP, DKK1 and IL-6 to HCC was 86.5%, 80.2% and 76.5%, respectively, and the specificity was 70.7% and 90.3% respectively, and the difference was statistically significant (P <0.05) 65.9%. The sensitivities and specificities of the three combined detection of HCC were 90.3% and 89.8% respectively. Conclusion DKK1 and IL-6 can be used as potential serum markers for HCC diagnosis. Combining with AFP can improve the detection efficiency.