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目的探讨研究白细胞介素1β(IL-1β)、IL-17A、IL-27、γ干扰素(interferon-γ,IFN-γ)、肿瘤坏死因子α(TNF-α)等检测在预测原发性肝癌患者的发生和临床分期中的应用价值。方法选择2012年8月—2015年12月台州市中西医结合医院收治的96例原发性肝癌患者作为研究对象,其中Ⅰ、Ⅱ期原发性肝癌组35例、Ⅲ期原发性肝癌组29例、Ⅳ期原发性肝癌组32例,另选择35例体检正常健康人作为对照组,分别检测和比较肝癌组和健康组血清中IL-1β、IL-17A、IL-27、IFN-γ、TNF-α水平的差异,并采用ROC曲线评估以上各细胞因子对原发性肝癌分期的预测效果。结果 IL-1β、IL-17A、IL-27、TNF-α等细胞因子对原发性肝癌患者诊断的ROC曲线下面积分别为0.857、0.998、0.982、0.982。IL-27对原发性肝癌患者不同分期的预测结果最好,AUC为0.940,cut-off值为307.05 pg/ml,敏感性为87.50%,特异性为89.06%,阳性预测值为83.56%,阴性预测值为75.50%,Youden指数为0.77。结论 IL-1β、IL-17A、IL-27、IFN-γ、TNF-α等细胞因子水平在原发性肝癌患者与健康人之间有明显差异(P<0.05),且IL-27对原发性肝癌患者的分期具有诊断意义。
OBJECTIVE: To investigate the effects of interleukin-1β (IL-1β), IL-17A, IL-27, interferon-γ and tumor necrosis factor α (TNF- The occurrence and clinical value of liver cancer patients. Methods A total of 96 primary hepatocellular carcinoma patients admitted to Taizhou Integrative Medicine Hospital from August 2012 to December 2015 were selected as the research object. Among them, 35 cases of primary hepatocellular carcinoma (Ⅰ and Ⅱ) and Ⅲ 29 cases, 32 cases of primary liver cancer in stage Ⅳ, and 35 cases of normal healthy subjects as the control group. The levels of IL-1β, IL-17A, IL-27 and IFN- γ, TNF-α levels, and the use of ROC curve to evaluate the above cytokines on the prediction of primary liver cancer staging effect. Results The area under the ROC curve for the diagnosis of HCC patients with cytokines such as IL-1β, IL-17A, IL-27 and TNF-α were 0.857, 0.998, 0.982 and 0.982, respectively. The predictive value of IL-27 in patients with primary liver cancer at different stages was the best, with AUC of 0.940, cut-off of 307.05 pg / ml, sensitivity of 87.50%, specificity of 89.06%, positive predictive value of 83.56% The negative predictive value was 75.50% and the Youden index was 0.77. Conclusion The levels of cytokines such as IL-1β, IL-17A, IL-27, IFN-γ and TNF-α in patients with primary liver cancer are significantly different from those in healthy people (P <0.05) Staging of patients with hepatocellular carcinoma has diagnostic significance.