Study On Realationship Between Trypsinogen-2and Primary Hepatic Carcinoma

Background and purpose Primary hepatic carcinoma is one of the common malignanttumors of the digestive system in Chin, only second to gastric cancer. In China, Cirrhosis afterhepatitis B virus infection is one of the most common factors resulting in primary hepaticcarcinoma. Primary hepatic carcinoma mainly includes such different pathological types ashepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma and the first two hybrids,HCC accounts for more than90%in PHC, and primary hepatic carcinoma is mainly referred toHCC in this article.The early clinical onset of HCC is rather hidden, which are easily to be ignored by thepatients. The rapid growth of tumor increases the liver capsule tension or its invasion of livercapsule causes intermittent or persistent dull pain or tingling in liver region. By this time, livercancer of the majority of patients has developed into the metaphase or advanced period, losingthe opportunity of surgical operation. Therefore, in-depth basic and clinical researches on HCC,and improving the early diagnosis rate of HCC have important significance for the treatment andimproving the prognosis of the patients. It has the advantage in assessing curative effective,metastasis according to serological changes in patients with liver cancer. Trypsinogen-2(trypsinogen-2, the Try-2) is first found in ovarian tumors, and then it is reported highlyexpressing in a variety of cancers. Our purpose is to study the correlation of Try-2and HCC,determine the cut-off value of differential diagnosing HCC, using the ELISA method fordetecting serum Try-2content.Method1. Test object The Military General Hospital of Beijing PLA from June,2011to November,2011, surgical diagnosis by liver biopsy to confirm the diagnosis of HCC, theincidence of<1year, without drugs and surgical treatment of HCC patients,34cases; byultrasound aided diagnosis of CT and other clear diagnosis of cirrhosis or decompensatedcirrhosis, the incidence of<1year,30cases of patients with cirrhosis without drug treatment;30cases of healthy people to the hospital medical center medical clearance.(2) Test Method All into a group of objects, liens fasting venous whole blood4ml, theabove specimens the same day or2-8°C cold storage until the next day After centrifugation, thesupernatant separation unit at-70°C frozen, unified using ELISA quantitative detection of serumpancreaticpepsinogen-2content difference; electricity chemiluminescence assay forquantification of serum AFP levels.Result HCC in the three groups of the serum trypsinogen-2content in the highest meanwas12.9μg/L, the standard deviation for the lowest6.9μg/L, the healthy group, the mean of 5.7μg/L, the standard deviation of2.1μg/L, liver cirrhosis group. Between any two of the groupdifferences were statistically significant (P <0.001)7.3μg/L for the critical value, the sensitivityof the differential diagnosis of hepatocellular carcinoma and healthy volunteers was88.2%,specificity was83.3%, area under the ROC curve0.9, for the differential diagnosis of livercirrhosis and hepatocellular carcinoma sensitivity was85.3%, specificity63.3%, the area underthe ROC curve of0.8; the original in the differential diagnosis of hepatocellular carcinoma andhealthy human serum trypsinogen-2and serum a tire protein diagnostic efficacy of serumalpha-fetoprotein sensitivity and specificity were94.1%and93.3%, superior to serumtrypsinogen-2sensitivity88.2%specificity83.3%; the combined detection of selection criteria:To determine any method found to be positive as the positive results, two methods are negativeas a negative, the diagnostic performance of sensitivity and specificity were97.1%and80.2%; inthe differential diagnosis of liver cirrhosis and hepatocellular carcinoma, serum trypsinogen-2and serum alpha-fetoprotein diagnostic performance, serum alpha-fetoprotein sensitivity andspecificity were91.2%and76.7%, better than serum trypsinogen-2sensitivity85.4%specificity63.3%, both joint detection conditions are the same. The diagnostic performance of sensitivityand specificity were94.1%and56.7%.Conclusions1. Because the relevance of Try-2and HCC, it can be used for the diagnosisof HCC. Try-2is a good indicator of out-patient screening, which has series of advantages, suchas high sensitivity, specificity and the rate of diagnostic coincidence. On the other hand, itprovide convenient for detection, operation, low cost and patient compliance.2. Serum trypsinogen-2and serum alpha-fetoprotein joint detection helps to reduce thehappening of missed diagnosis in clinical screening, but the joint detection can improve thedetection sensitivity of hepatocellular carcinoma, while its specificity decreased markedlyserology positive findings should be selected imaging studies or liver puncture to take a biopsy,which can be achieved tumors at high risk of regular screening for early detection, earlytreatment, there is high clinical value.