摘要
目的评价血清唾液酸(SA)在肝癌诊断和疗效监测中的临床价值。方法检测2011年1月至2013年1月云南省第三人民医院就诊的163例肝癌(原发性肝癌135例,转移性肝癌28例)、234例其他肝病患者和300名健康人血清SA含量;采用高、低两个浓度的样本,每日测量4次,连续测量5 d,评价SA试剂盒的批内和批间变异系数(CV);用135例原发性肝癌和300名健康人血清SA检测数据绘制受试者工作特征(ROC)曲线确定SA的临界值,并评价SA的诊断价值。同时,对76例肝癌患者治疗前和治疗后1、7、14 d和1、3、6、9个月的SA水平进行追踪监测和评价分析。采用SPSS 17.0进行统计分析。结果低浓度水平样本的批内和日间变异分别为2.4%和3.2%;高水平样本的批内和日间变异分别为2.2%和3.1%。用ROC曲线确定SA的临界值为659 mg/L,用其诊断肝癌的敏感度和特异度分别为63.7%(86/135)、94.6%(105/111)。肝癌患者血清SA水平(726±123)mg/L明显高于其他肝病组(552±128)mg/L和健康对照组(599±62)mg/L,(U值分别为1832.52和887.00,均P<0.01)。随访76例原发性肝癌患者,其血清SA水平在治疗后1周升高(817±139)mg/L,(t=-3.272,P<0.05);持续到治疗后1个月(782±127)mg/L,(t=-2.694,P<0.05);在第3个月时,SA降低至治疗前水平(662±108)mg/L,(t=1.225,P>0.05);第6个月时降低至(615±124)mg/L,(t=1.999,P<0.05),接近健康对照组水平;有63例肝癌患者SA水平与治疗前相比降低,与临床病情的符合率为82.9%(63/76,Kappa值=0.79)。有5例肝癌患者在治疗后第9个月复发,SA水平明显增高(939±155)mg/L。结论血清SA对肝癌的辅助诊断和疗效监测可能有临床价值。
Objective To investigate the clinical value of serum sialic acid （SA）in the diagnosis and therapy of liver cancer patients.Methods One hundred and sixty-three liver cancer patients （135 primary hepatic carcinoma patients and 28 metastatic hepatic carcinoma patients）,234 benign liver disease patients of the Third People＆#39;s Hospital of Yunnan Province and 300 healthy controls from January 201 1 to January 2013 were enrolled.The concentration of serum SA was tested by ROCHE P800.The intra-assay and inter-assay coefficient of variation （CV）of SA kit were evaluated by using low and high concentration samples,measured for 5 days and 4 times each day.Receiver operating characteristic （ROC） curve of 135 cases of primary hepatic carcinoma and 300 healthy controls was used to determine the cut-off value of SA. The area under the curve （AUC）was used to evaluate the diagnostic value of SA.The varies of serum SA level in 76 cases of primary hepatic carcinoma patients were monitored before therapy and 1 day,7 day,14 day,1 month,3 month, 6 month and 9 month after treatment.SPSS 17.0 was used to analyze the results.Results The intra-assay and inter-day CVs for low level sample were 2.4% and 3.2%,respectively,and for high level sample were 2.2% and 3.1%, respectively.The cut-off value of serum SA was 659 mg/L for liver cancer,the sensitivity and specificity were 63.7%（86/135）and 94.6% （105/111）,respectively.Serum SA level of liver cancer group [（726±123）mg/L]was higher than that of liver benign disease patients group [（552±128）mg/L]and healthy controls group [（599±62）mg/L,U values were 1832.52 and 887.00,P〉0.01],respectively.Seventy-six primary hepatic carcinoma patients were followed-up during treatment,of which serum SA levels elevated to （817±139）mg/L[t=-3.272,P〉0.05]1 week after treatment and kept at high level until 1 month after treatment [（782±127）mg/L,t=-2.694,P〉0.05].At 3 month after treatment,SA level decreased to [（662±108）mg/L,t=1.225,P〈0.05],appro
出处
《肝脏》
2014年第3期179-183,共5页
Chinese Hepatology
关键词
肝肿瘤
肿瘤标记
生物学
诊断
Liver neoplasms
Tumor markers,biological
Diagnosis
