| Background:Primary hepatic cancer(PHC),a common malignant,with a high incidence and mortality rate,has a serious influence on the living standards of residents in China.PLC include several pathological type,such as hepatocellular carcinoma(HCC),intrahepatic cholangiocarcinoma(ICC)and mixed cell carcinoma,and HCC is the most common one in clinic.Nowadays,HCC is diagnosed by abdominal ultrasound,CT or MRI imaging and Alpha fetoprotein(AFP)serologic test.HCC is cured by surgery,minimally invasive treatment,radiation therapy,biological immune therapy and other treatments.Patients who suffered from HCC,with a low chemotherapy sensitivity,were too late to have an operation,so physcians would like to use minimally invasive treatment.Recently,radiofrequency ablation(RFA)and transarterial chemotherapy embolization(TACE),as the representative way in the field of minimally invasive treatment,has been widely used in local radical or palliative treatment of HCC.It is found that Heat Shock Protein 70(HSP70),higher sensitivity and specificity than AFP,is related to the occurrence and development of HCC,and few minimally invasive treatment,such as RFA and TACE,related with HSP70 is reported.Objectives:To research the clinical diagnostic values of combined detection of tissue and serum HSP70 in patients with HCC.To investigate the change and clinical value of serum HSP70 before and after minimally invasive therapy in HCC patients.Methods:(1)The serum HSP70 in 80 patients with hepatitis B related hepatocellular carcinoma,66 patients with hepatitis B related cirrhosis,78 patients with chronic hepatitis B and 83 healthy control subjects were tested with enzyme-linked immunosorbent assay(ELISA),and the cut off value on the diagnosis of HCC were comfirmed with the receiver-operating characteristic(ROC)curve.(2)The HSP70 in 80 cases of liver cancer tissue and 80 cases of non-cancerous adjacent tissue were tested with Immunohistochemistry,and the diagnose,clinical treatment and prognosis of HSP70 in HCC were assessed.(3)The serum HSP70 in 36 cases of HCC patients who accept RFA treatment,54 cases with TACE treatment and 28 cases uesd TACE+RFA were tested with ELISA.The levels of HSP70 before-treat,1-day,7-day,1-month,3-month and 6-month after minimally invasive therapy were compared.And the significance of HSP70 in the patients with HCC after minimally invasive therapy was evaluated.Results:(1)The HSP70 in serum of HCC patients was significantly higher than hepatitis B,cirrhosis patients and the healthy control group(P<0.05).There was no differences between hepatitis B and cirrhosis group,hepatitis B and the healthy control group,cirrhosis and the healthy control group(P>0.05).ROC was 0.929(95% CI: 0.877 ~ 0.877;P < 0.01).The diagnostic sensitivity and specificity of HCC were 90.0% and 86.7% when the HSP70 was calculated as the lowest critical value as the 3.030ug/l and at the same time the Youden index was utmost,reaching 0.767.(2)The expressions of HSP70 in cancerous tissues were higher than those in NCAT(P<0.05).HSP70 expression was closely related with the number of tumors size and tumor differentiation(P < 0.05),while few connected to age,sex,AFP level,the stage of TNM,transfer,portal vein tumor emboli,bile duct tumor emboli,degree of liver cirrhosis,HBsAg positivity.(P > 0.05).What’s more,HSP70 in patients’ overall survival time regression coefficient is 1.451,which showed the negative correlation with mortality.(3)After the treatment of TACE,RFA and TACE+RFA the serum HSP70 of HCC patients increased,peaked in 7 days,and then gradually declined,finally was lower than the preoperative levels.Among them,the TACE + RFA group in HSP70 increased the highest level after the treatment,next RFA,again was TACE group(P<0.05).Conclusions:The serum HSP70 expressed highly in the HCC patient’s tissue and expressed low in hepatitis B,cirrhosis group and the healthy control group.HSP70 has a high sensitivity and specific degree for the treatment of HCC.Compared with the tissue adjacent to carcinoma,HSP70 in liver tissue expressed higher,HSP70 is correlated with HCC tumor number and differentiation.After minimally invasive treatment on HCC,HSP70 has a transient rise and then decline gradually and HSP70 in TACE+RFA rise highest and fastest.HSP70 expression may have a correlation with survival time,it is necessary to have a futher explore on HSP70 for the effect in HCC diagnosis and prognosis. |
