| 血清载脂蛋白A-1检测在HBV相关肝癌中的临床价值 |
| 投稿时间：2016-08-29 修订日期：2016-09-17 点此下载全文 |
| 引用本文：高国生,董飞波,颜卫华.血清载脂蛋白A-1检测在HBV相关肝癌中的临床价值[J].医学研究杂志,2017,46(4):109-112 |
| DOI：
10.11969/j.issn.1673-548X.2017.04.029 |
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| 基金项目:浙江省宁波市社发重大项目（2016C51005）；浙江省宁波市医学科技计划项目（2013A11） |
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| 中文摘要:目的 探讨血清载脂蛋白A-1（Apo A-1）检测在乙型肝炎病毒（HBV）相关肝癌中的临床价值。方法 选取2010年1月~2014年12月笔者医院慢性HBV感染患者362例，包括88例慢性乙型肝炎（以下简称慢乙肝）、94例乙肝肝硬化、18例乙肝肝癌（无肝硬化基础）和162例乙肝肝硬化合并肝癌，另选取45例健康体检者作为正常对照组，检测所有入选者的血清Apo A-1、AFP和其他实验室指标，对检测结果进行统计学处理。结果 血清Apo A-1和AFP水平在所有组别中的总体差异均有统计学意义（F=29.86，χ2=112.53，P均=0.000）。随着疾病进展，血清Apo A-1水平逐步明显下降（P均 < 0.05），但正常对照组与乙肝肝癌组（无肝硬化基础）、慢乙肝组与乙肝肝硬化合并肝癌组、肝硬化与乙肝肝硬化合并肝癌组的Apo A-1水平差异均无统计学意义（P均 > 0.05）。Child-Pugh评分A、B、C级肝癌患者血清Apo A-1水平之间的比较，差异均有统计学意义（P均 < 0.05）。肝癌患者Child-Pugh评分A级患者显著高于相对应的肝硬化患者（t=-3.02，P=0.003），而B、C级患者之间的血清Apo A-1水平比较，差异无统计学意义（t=0.52、1.19，P=0.610、0.240）。TNM分期Ⅰ+Ⅱ肝癌患者血清Apo A-1水平显著高于TNM分期Ⅲ+Ⅳ肝癌患者（t=3.85，P=0.000）。结论 HBV相关肝癌患者血清Apo A-1水平与是否合并肝硬化、Child-Pugh评分及TNM分期相关，肝功能储备情况和机体的应激反应等多个因素影响血清Apo A-1的表达。 |
| 中文关键词:乙型肝炎 载脂蛋白A-1 甲胎蛋白 肝癌 |
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| Clinical Value of Serum Apolipoprotein A-1 (Apo A-1) Detection in HBV-related Liver Cancer |
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| Abstract:Objective To investigate the clinical value of serum apolipoprotein A-1 (Apo A-1) detection in HBV-related liver cancer. Methods Totally 362 cases of patients with chronic HBV infection were enrolled from January 2010 to December 2014 in our hospital,including 88 cases of chronic hepatitis B,94 cases of HBV-related liver cirhosis,18 cases of HBV-related liver cancer (without cirrhosis) and 162 cases of liver cirrhosis merged cancer. At the same time,45 cases of healthy people were selected for normal control.The serum Apo A-1, AFP and other laboratory markers were detected, and the test results were statistically analyzed. Results The difference of Serum Apo A-1 and AFP levels in all groups was statistically significant (F=29.86, χ2=112.53, P=0.000). As the disease progressed, the serum levels of Apo A-1 gradually decreased (P < 0.05).But the difference of Apo A-1 level between normal control and HBV-related liver cancer group (without cirrhosis), chronic hepatitis B and liver cirrhosis merged cancer group, liver cirrhosis and liver cirrhosis merged cancer group was not statistically significant (all P > 0.05). The liver cancer patients with Child-Pugh score A, B, C had different serum Apo A-1 levels (all P < 0.05); The serum Apo A-1 level of liver cancer patients with Child-Pugh score A was significantly higher than that of liver cirrhosis (t=-3.02, P=0.003), but the differences of serum Apo A-1 levels between liver cancer and liver cirrhosis patients with Child-Pugh score B and C were not statistically significant (t=0.52,1.19, P=0.610,0.240).The serum Apo A-1 levels of liver cancer patients with TNM stage Ⅰ and Ⅱwere significantly higher than those with TNM stage Ⅲ and Ⅳ(t=3.85,P < 0.001). Conclusion The serum Apo A-1 levels of HBV-related liver cancer patients are related with cirrhosis, Child-Pugh score and TNM stage,and the liver reserve function,the body's stress response and many other factors may contribute to the expression of serum Apo A-1. |
| keywords:Hepatitis B Apolipoprotein A-1 AFP Hepatic carcinoma |
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