Clinical Application Value Of Serum SAxl In Primary Liver Cancer

Objective:To detect the content of soluble receptor tyrosine kinase(sAxl)in serum of patients with primary liver cancer(PHC),and to explore the clinical value of serum sAxl in PHC.Methods:A total of 397 hospitalized patients were collected,including 194 cases of PHC(PHC group).128 cases of cirrhosis(cirrhosis group)and 75 cases of other chronic liver diseases(other liver diseases group),and another 82 cases of healthy people(healthy group)were selected for physical examination.All patients' laboratory test results and imaging test results were recorded.Serum sAxl levels were detected by enzyme-linked immunosorbent assay(ELISA),and the level of AFP levels were detected by chemiluminescence method.To analyze the changes of serum sAxl in each group,the relationship between serum sAxl and PHC patients with different clinicopathologica-1 features and different tumor characteristics,and the correlation between serum sAxl and clinical experimental indicators,The diagnostic value of serum sAxl for PHC was analyzed by using the area under the receiver operating characteristic curve(ROC-AUC).Results:(1)Serum sAxl levels in the PHC group were significantly higher than those in the cirrhosis group,other liver disease groups,and healthy groups(all P<0.05).(2)In patients with PHC,the level of serum sAxl showed no significant difference in ages,gender,nationality,history of smoking,drinking,hypertension and diabetes(all P>0.05).The level of serum sAxl in HCV infection-related PHC was significantly higher than HBV infection-related PHC(P=0.003);the level of serum sAxl of PHC with cirrhosis was significantly higher than PHC without cirrhosis and cirrhosis group(both P<0.05);the level of serum sAxl of patients with Child-Pugh grade A was significantly lower than Child-Pugh grade B(P<0.001),and there was no significant difference between with Child-Pugh grade C patients(P>0.05).(3)In patients with PHC,the level of serum sAxl of patients with TNM stage ? was significantly lower than patients with TNM stage ?(P=0.013);there were no significant differences between tumor size(<3cm,3-5cm,>5cm)(P=0.247);the level of serum sAxl of patients with multiple tumors was significantly higher than patients with single tumors(P=0.036);the level of serum sAxl of patients with portal vein tumor thrombus was significantly higher than patients without portal vein tumor thrombus(P=0.036).(4)Serum sAxl was negatively correlated with PLT,ALB and PA in PHC group,positively correlated with ALT,AST,GGT,TBIL,TBA,ALP,CysC,PT and INR,and had no correlation with Cr;serum sAxl was positively correlated with Child-Pugh grading and MELD score in PHC group.Serum sAxl and AFP were not correlated in PHC group,cirrhosis group and healthy group,and weak positive correlation in other liver disease group.(5)Under the cut off value of 19.59 ng/ml,the serum sAxl diagnosis of PHC has a ROC-AUC 0.929(95%CI:0.898-0.961),and the sensitivity was 86.7%,the specificity was 92.7%.AFP diagnosis of PHC has a ROC-AUC of 0.851(95%CI:0.806-0.896),and the sensitivity was 60.6%,the specificity was 100%.The ROC-AUC of serum sAxl was higher than AFP(Z=3.507,P=0.001).The ROC-AUC combined with serum sAxl and AFP was 0.953(95%CI:0.927-0.979),the sensitivity was 90.0%,the specificity was 97.6%,and the ROC-AUC of combined detection was higher than both tested separately(Z=2.715,P=0.007;Z=5.396,P<0.001).Conclusion:1.The level of serum sAxl in patients with PHC is significantly increased,suggesting that sAxl may be involved in the development of PHC;2.Serum sAxl can be used as one of the indicators for liver function damage and PHC prognosis risk assessment;3.Serum sAxl can be used as a biomarker for diagnosis of PHC,and the sensitivity and ROC-AUC of sAxl are better than AFP.Combined detection with AFP is superior to single detection.