Study On The Diagnostic Value Of Serum SAxl In Primary Liver Cancer

Objective To detect the expression levels of serum sAxl of the object of study in group PLC,group hepatitis B cirrhosis,group hepatitis B virus infection and group healthy control and investigate the diagnostic value in PLC of serum sAxl or combined detection with AFP.Methods 80 cases serum of PLC patients,80 cases serum of hepatitis B cirrhosis,80 cases serum of hepatitis B patients and 80 cases serum of healthy controls which provided from the Affiliated Tumor Hospital of Guangxi Medical University were enrolled in the experiment and composed of group PLC,group hepatitis B cirrhosis,group hepatitis B and group healthy control.Quantitative sandwich ELISA was used to detect the concentration of serum sAxl in each group.ECLIA was used to detect the concentration of serum AFP.Receiver operating characteristic(ROC)was used to evaluate the diagnostic value of PLC.Results 1.The serum sAxl expression levels in group PLC was 2020(1546,2526)pg/ml,group LC was 1505(1004,1911)pg/ml,group HBV was 489(296,887 pg/ml)and group HC was 678(469,893)pg/ml,The serum sAxl expression levels in group PLC was significantly higher than other groups,the difference was statistically significant among all groups(P<0.05),excepted group hepatitis B virus and group healthy control had no significant difference,the differences were statistically significant in other groups between(P<0.05).2.The expression levels of serum sAxl in AFP positive and AFP negative PLC were 2004(1554,2469)pg/ml,2100(1442,2717)pg/ml respectively,the difference was not statistically significant(P>0.05).Significant difference was found between AFP negative PLC and other groups such as group LC,group HBV or group HC(P<0.05).3.The expression levels of serum sAxl in group PLC BCLC 0 and A phases,BCLC B stage,BCLC C stage,BCLC D stage were 1984(1532,2511)pg/ml,2060(1399.,2724)pg/ml,1940(1546,2335)pg/ml,2524(1524,4355)pg/ml respectively.There was no significant difference between the groups(P>0.05).4.To identify the PLC group with non PLC group,the AUC was 0.765 for AFP.When the Cut-off value of AFP was 15600 pg/ml,the sensitivity was 67.5%,the specificity was 70.0%.The AUC of serum sAxl diagnosis PLC alone was 0.888,when serum sAxl Cut-off value was 1202pg/ml,the sensitivity was 95.0%,the specificity was 73.3%.The AUC of AFP combined with serum sAxl was 0.914,the sensitivity was 96.3%,the specificity was 72.5%.5.When the group PLC was identified with the liver disease group,the AUC was 0.703 of AFP.When the Cut-off value of AFP was 21480 pg/ml,the sensitivity was 66.3%,the specificity was 61.9%.The AUC of serum sAxl diagnosis PLC alone was 0.840,when Cut-off value of serum sAxl was 1243pg/ml,the sensitivity was 93.8%,the specificity was 61.9%.The AUC of AFP combined with serum sAxl was 0.875,the sensitivity was 83.8%,the specificity was 73.8%.6.When the early PLC(BCLC stage 0+A)and non PLC group identificated,AUC was 0.705 of AFP.When the Cut-off value of AFP was 19870 pg/ml,the sensitivity was 58.8%,the specificity was 74.2%.AUC in diagnosis of PLC of serum sAxl alone was 0.881,when the Cut-off value of serum sAxl was 1202pg/ml,the sensitivity was 94.1%,the specificity was 73.3%.AUC of AFP combined with serum sAxl was 0.899,the sensitivity was 76.5%,the specificity was 86.7%.7.When the early PLC(BCLC stage 0+A)and the liver disease group identified,AUC was 0.636 of AFP.When the Cut-off value of AFP was 19870 pg/ml,the sensitivity was 58.8%,the specificity was 61.3%;AUC in diagnosis of PLC of serum sAxl alone was 0.834,when the Cut-off value was 1281 pg/ml,the sensitivity was 91.2%,the specificity was 64.4%.The sensitivity of AFP and serum sAxl parallel combined diagnosis of PLC was 100%,the specificity was of serial combined diagnosis of PLC was 82.5%.8.When AFP negative PLC and non PLC group identified,AUC was 0.898,the Cut-off value of sAxl was 1301pg/ml,the sensitivity was 84.6%,the specificity was 76.3%.When AFP negative PLC and the liver disease group identified,AUC was 0.849,the Cut-off value of sAxl was 1555pg/ml,the sensitivity was 73.1%,the specificity was 74.4%.9.Serum sAxl in group PLC was related with tumor thrombus and smoking(P<0.05).But it was irrelevant to the gender,age,hepatitis B background,drinking,tumor diameter,vascular invasion,lymph node metastasis and other clinical pathological features(P>0.05).Conclusion 1.The expression levels of serum sAxl in group PLC was significantly higher than that in other groups,suggesting that serum sAxl may be related to the occurrence and development of PLC.Serum sAxl had not difference in the expression of AFP positive PLC and AFP negative PLC,but significant difference was found between AFP negative PLC and controls,suggesting that serum sAxl may have potential diagnostic value for the AFP negative PLC.Moreover,the serum sAxl was highly expressed in the PLC stages,there was no statistical significance.But it was not yet clear that serum sAxl was correlated with PLC stages.2.The diagnosis efficiency of serum sAxl in the identification of PLC and early PLC maybe superior to AFP.It was suggested that serum sAxl may have potential diagnostic value for the diagnosis of liver cancer,early or AFP negative liver cancer.3.Serum sAxl may be a serum marker associated with or without cancer emboli and smoking.