| BackgroundHepatocellular carcinoma (HCC) is a common tumor which currently ranks fifth in populationwho suffer from this and the third in terms of mortality rate in the world, in the meantime, the incidence ofhepatocellular carcinoma is increasing year by year. Hepatocellular carcinoma occurs frequently inmales,and the incidence of hepatocellular carcinoma is increasing by the growing of age. In countries witha high incidence of hepatocellular carcinom, even some people who are under20years old was diagnosedwith liver cancer. Hepatocellular carcinoma is characterized by hidden onset and spreads rapidly with highmortality, posing threats to people’s health. In addition to that, the occurrence of HCC is as a result ofvarious factors and multi-channels and it is multi-stage after long time.In the following, Cirrhosis is a majorcause of liver cancer, and other factors such as viral infections (eg, HBV, HCV), excessive alcoholconsumption, smoking, intake of aflatoxin B1, vinyl chloride, diabetes, and genetic diseases (such ashemochromatosis and disease, α1-antitrypsin deficiency) can also lead to liver cancer. It is usually observedthat the overlapping factors significantly enhance the risk of liver cancer.People always think that subclinical stage of hepatocellular carcinoma is the best treatment.Subclinical hepatocellular carcinoma refers to liver cancer without clinical symptoms and it is usuallyfound in high-risk population during the physical examination. More often than not, people hope to cureliver cancer through early diagnosis and treatment, but in fact, currently surgical resection is a preferredmethod of treatment for liver cancer, as well as that, liver cancer can also be treated by a comprehensivetreatment approach including microwave ablation, TACE, radiofrequency ablation, percutaneous ethanolinjection, radiotherapy liver transplantation and biological therapy etc. And of course if early diagnosis ofliver cancer could be operated successfully, the survival length for liver cancer patients can be improved byat least five years, which obviously brings a relatively positive therapeutic effect. Today, the main methodof diagnosis of HCC includes laboratory examinations, imaging and pathology. Although pathologydiagnosis is considered to be the most accurate method for liver cancer, people can only obtain diseasedtissue by surgery or biopsy, which is not easily accepted by the majority of patients. The detection of serum tumor markers is more and more popular among people due to the character of high specificity, highsensitivity, less pain, etc. AFP is a specific high protein of liver cancer cells, and it is the first serum tumormarker which detects and traces patients who suffer from liver cancer. Since AFP in the liver of hepatitis,cirrhosis and other diseases has increased, and presents certain false positive rate, no tumor markers can betotally diagnosed with liver cancer currently. However, early diagnosis rate of liver cancer can be improvedby joint detection, and therefore the discover of new serum tumor markers is of great significance.ObjectiveThe study aims to detect AFP(a-FetoProtein)、 PEG10(Paternally expressed gene10)、IQGAP1（IQ motif containing GTPase activating proteins1）、CK19（cytokeratin19）levels in liver cancer,cirrhosis, normal serum explore four separate clinical value of serum, and joint inspection and testing. Inaddition, the study is made to explore their diagnostic value in HCC, improve the diagnostic rate of HCCand discover new ideal serum tumor markers.Materials and MethodsDuring the period from December2012to November2013, we collected156blood samples fromhospitalized patients in Henan Provincial People’s Hospital as research subjects andhospital examinationincluded112males and44females, with the age range between32-81years old (mean57±10.5years).Among those were96patients with hepatocellular carcinoma,30patients with cirrhosis,30healthy people,all of whose serum samples were stored in a refrigerator of-100degree after centrifugation. Those fourexaminations we did in the laboratory were AFP, PEG10, IQGAP1and CK19. Detection of these threegroups of subjects was proceeded by using enzyme-linked immunosorbent assay (ELISA) AFP,CK19,PEG10and IQGAP1with a analysis of varianceto compare the method of data group. SPSS19.0software was used during the process of analysis.Results1. Three groups of patients with serum AFP, CK19, PEG10and IQGAP1level comparativeanalysis of variance, the difference was statistically significant (p<0.05). AFP, CK19, PEG10andIQGAP1expression in HCC was significantly higher than the healthy group and the cirrhosis group, thedifference was statistically significant (p<0.05).2. These markers of AFP, CK19, PEG10and IQGAP1sensitive diagnosis of liver cancer were 85.4%、42.9%、72.7%and78.6%。The specificity was80.0%、87.2%、86.9%and83.3%。.3. These markers of CK19, PEG10, IQGAP1, joint detection method AFP parallelexperiment,which could significantly improve the sensitivity of HCC detection, combined detectionmethod using AFP,CK19,PEG10,IQGAP1series of tests that can detect HCC is to improve the specificityof.4. These serum tumor markers levels of CK19, PEG10, IQGAP1of the AFP-negative HCCvariancecomparative analysis, CK19in AFP-negative HCC group was significantly higher than thecirrhosis group, the difference was statistically significant (p <0.05); The level of PEG10, IQGAP1at livercancer and cirrhosis of the AFP-negative group, the difference was not statistically significant (p>0.05).5. These serum tumor markers of CK19has accurate diagnosis of hepatocellular carcinomahighest degree of AFP-negative, the sensitivity was50%and specificity of90.9%.Conclusions1. These Serumlevels of AFP, CK19, PEG10and IQGAP1in hepatocellular carcinoma group arehigher than the cirrhosis group and the healthy control group.2. These markers of CK19, PEG10and IQGAP1can be used as a diagnostic serum markers ofliver cancer,which could combined detection of AFP and could increasesensitivity or specificity.3. The marker of CK19diagnostic accuracy of AFP-negative HCC highest in the early diagnosisof liver cancer may be a valuable complement to AFP. |
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