| Background Primary Hepatocellular Carcinoma(hereinafter referred to as liver cancer)is the most important type of liver cancer.Its clinical incidence is 12% of all the malignant tumors in our country.The mortality rate is only lower than lung cancer,which is the second and fifth of the male and female cancer cases respectively,and with the aggravation of aging population,the incidence and mortality of liver cancer are increasing year by year.The detection of serum markers is sensitive,fast,convenient.It is of great value for the early diagnosis of liver cancer.At present,the serum marker of liver cancer is the alpha fetoprotein AFC,which is most widely used in clinic,but its sensitivity is low.Finding tumor markers with high sensitivity to the diagnosis of liver cancer is of great significance for clinical diagnosis and treatment.CXCL13 is a member of the chemokine CXC family,which has the function of regionalization and is closely related to the microenvironment of tumor cells.TK1 is the key enzyme in the pyrimidine remedial pathway,and participates in the DNA synthesis of tumor cells.NGAL is a conjugate of matrix metalloproteinase9MMP9.It can activate MMP9 by combining with MMP9 and may be involved in the diffusion and metastasis of cancer cells.There are many reports of abnormal expression of these three factors in a variety of malignant tumors.Objective:To investigate the expression of serum CXCL13,TK1 and NGAL in liver cancer,benign liver disease(chronic hepatitis and cirrhosis)and healthy population.and its relationship between these three tumor markers and clinicopathology,their diagnostic value for liver cancer.Methods:120 cases of primary hepatocellular cacer hospitalized in the Department of our hospital,60 cases of benign liver disease and 60 cases of health volunteer from August 2015 to August 2017 were selected as study objectives,Which are corresponding to liver cancer group,benign liver disease group and healthy group.The basic information of three groups were collected.The blood serum of all objectives were collected and stored under-80 ?.Serum CXCL13 and serum NGAL were measured by enzyme-linked immunosorbent assay(ELISA).Serum TK1 level was detected by Western blot and enhanced chemiluminescence(ECM).The difference in the expression of CXCL13,TK1 and NGAL in the liver cancer group,the benign liver disease group and the healthy group was compared,and the statistical difference was studied.The receiver operating characteristics curve,(ROC curve)was used to assess the diagnostic efficacy of the three markers,its sensitivity and specificity are calculated.And the differences of PHC patients' pathological data(sex,age,TNM staging,tumor size,tumor number,lymph node metastasis,and liver cirrhosis)with the serum levels of CXCL13,TK1,and NGAL were studied.Results:(1)The comparison of basic information.There was no significant difference in sex,age distribution and average age between the three groups(P > 0.05).There was no significant difference between the liver function classification in the liver cancer group and the benign disease group(P > 0.05).(2)The expression of three serum tumor markers in three groups of patients:the serum CXCL13 concentration in the liver cancer group,the benign disease group and the healthy group were: 89.05 ± 22.14,66.32 ± 14.69,47.38 ± 6.84 respectively;the serum concentration of TK1 in the liver cancer group,the benign disease group and the healthy group were 31.56 ± 11.38,1.59 ±1.61,1.14 ± 0.39,respectively;and the concentration of NGAL in the liver cancer group,the benign disease group and the healthy group were:42.57 ± 9.13,25.94 ± 7.64,13.79 ± 3.21.all datas showed statistically significant difference.Compared with each two groups,the serum concentration of the three indexes in liver cancer group was significantly higher than the benign disease group,and the benign disease group was significantly higher than the healthy group(P < 0.05).(3)The diagnostic efficiency of three serum tumor markers for PHC: the area under ROC curve of serum CXCL13,TK1 and NGAL were 0.902,0.784,0.723,respectively.All of them have high diagnostic value,and CXCL13 has very high diagnostic value.The sensitivity and specificity of CXCL13 were 86.00% and 75.71%,respectively,and the sensitivity and specificity of TK1 were 80.85% and 69.86%,and the sensitivity and specificity of NGAL were 72.22% and 68.18% respectively.(4)The relationship between serum CXCL13 and the pathological features of PHC patients:in 120 patients with PHC,serum CXCL13 levels were not statistically significant in sex,age,tumor diameter,tumor number,and whether or not it was associated with cirrhosis(P> 0.05).There were statistical differences in TNM staging,tumor diameter and lymph node metastasis.Significance(P < 0.01),serum CXCL13 content in patients with stage III~IV was significantly higher than that in I~II stage.The serum CXCL13 content in patients with tumor diameter > 5cm was significantly higher than that of tumor diameter <5cm.The serum CXCL13 content in patients with lymph node metastasis was significantly higher than that of patients without metastasis.(5)The relationship between serum TK1 and the pathological features of PHC patients: in120 patients with PHC,serum TK1 levels were not statistically significant in sex,age,tumor diameter,tumor number,lymph node metastasis,and whether there were cirrhosis(P > 0.05).The difference was statistically significant in the stages of TNM(P < 0.01).The serum TK1 level in patients with stage III~IV was significantly higher than that in I~II phase.(6)The relationship between serum NGAL and the pathological features of PHC patients:in 120 patients with PHC,serum NGAL levels were not statistically significant in sex,age,tumor diameter,and whether or not it was associated with cirrhosis(P > 0.05).There were statistical differences in TNM staging,tumor number,and lymph node metastasis.Significance(P < 0.01),serum NGAL content in patients with stage III~IV was significantly higher than that in I~II stage.The serum NGAL content in patients with more tumor number was significantly higher than that of single tumor number.The serum NGAL content in patients with lymph node metastasis was significantly higher than that of patients without metastasis.Conclusion:TK1,NGAL and CXCL13 are closely related to the DNA synthesis of tumor cells,proliferation and metastasis of tumor cells,and the microenvironment of tumor cells.Serum TK1,NGAL and CXCL13 can be used as serum markers of liver cancer.It is of high value for the diagnosis of primary liver cancer.It can be used for clinical diagnosis,or combined with other serum markers and imaging methods.The clinical diagnosis of liver cancer.Serum TK1,NGAL and CXCL13 are related to the tumor diameter,tumor number,TNM stage,lymph node metastasis in patients with PHC. |
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