肝细胞癌术后转移复发MR分子影像学特征与外周血肿瘤标志物表达调控的相关研究

发布时间：2018-02-11 05:57

本文关键词： 肝细胞肝癌 EGFL7 OPN PGE2 肝细胞肝癌肿瘤标记生物学转移复发磁共振成像　出处：《山东大学》2014年博士论文　论文类型：学位论文

【摘要】：第一部分EGFL7、OPN和PGE2的表达与肝细胞肝癌复发转移的相关性研究目的：在肝癌患者,肿瘤侵袭、转移和复发是造成死亡最常见的原因,因此与肝癌治疗和预后判断相关的因子非常重要。通常临床上诊断肝癌最常用的血清学标志物是甲胎蛋白AFP和一些特定的肝脏的酶类,当然还有体格检查和影像学技术的辅助。良好的的血清标志物具有方便筛选和早期诊断的作用,能显著的改善预后。方法：我们开展了一项回顾性队列研究,分析了90例具有单个或者多点肝癌的肝硬化患者。我们采用ELISA的方法检测了他们EGFL7, OPN和PGE2的水平。结果：在肝癌患者这些因子的水平与健康人相比具有显著的不同。在肝细胞肝癌患者患者EGFL7, OPN和PGE2的水平分别为：132.11pg/L,11.77ng/mL,,179.37pg/mL,这些数据显著的高于健康志愿者EGFL7, OPN和PGE2的的水平,分别为：23.03pg/mL,2.31ng/mL,47.36pg/mL。结论：EGFL7, OPN和PGE2可以用来筛选和监控高危人群中肝癌的发生,并且会改善这些患者的预后。第二部分DWI联合外周血清肿瘤标志物对肝癌术后转移复发早期诊断的价值目的：探讨DWI联合外周血清肿瘤标志物指标对肝癌术后转移复发早期诊断的价值。方法：回顾分析116例原发性肝癌术后转移复发的病历资料,所有患者均经手术或者穿刺活检病理证实确诊为肝癌。患者均行化学发光法检测血清甲胎蛋白(AFP)、甲胎蛋白异质体3(AFP-L3)、癌相关抗原(CA125、CA199)、癌胚抗原(CEA)水平,其中AFP值均1210ng/L,所有患者均行MRI常规扫描和DWI扫描。结果：外周血血清肿瘤标志物AFP-L3、CA199、CA125、CEA灵敏度及特异度随肿块增大而升高,4项肿瘤标志物联合检测的敏感度及特异度最高。DWI联合4项肿瘤标志物检测的诊断敏感度、特异度可提高到98.4和95.0%。结论：DWI联合肿瘤标志物检测对肝癌术后转移复发监测敏感有效,为肿瘤术后评估疗效和追踪复查提供一条新途径。
[Abstract]:The relationship between the expression of EGFL7 and PGE2 and the recurrence and Metastasis of Hepatocellular carcinoma. Objective: in patients with liver cancer, invasion, metastasis and recurrence are the most common causes of death. Therefore, the factors related to the treatment and prognosis of HCC are very important. The most commonly used serological markers in clinical diagnosis of HCC are alpha-fetoprotein AFP and some specific liver enzymes. Of course, there are physical examination and imaging techniques. Good serum markers can be used for screening and early diagnosis, and can significantly improve prognosis. Methods: a retrospective cohort study was conducted to analyze 90 patients with liver cirrhosis with single or multiple liver cancer. The levels of EGFL7, OPN and PGE2 were measured by ELISA. Results: the levels of EGFL7, OPN and PGE2 in HCC patients were significantly different from those in healthy controls. The levels of EGFL7, OPN and PGE2 in HCC patients were 1: 132.11pg / L 11.77ng / mL, 179.37pg / mLrespectively, which were significantly higher than those in healthy volunteers (EGFL7, OPN and PGE2). They are:: 23.03 PG / mL 2.31 ng / mL 47.36 PG / mL. Conclusion OPN, OPN and PGE2 can be used to screen and monitor the occurrence of liver cancer in high risk population and improve the prognosis of these patients. The value of DWI combined with peripheral blood tumor markers in the early diagnosis of postoperative metastasis and recurrence of hepatocellular carcinoma. Objective: to investigate the value of DWI combined with peripheral blood tumor markers in the early diagnosis of postoperative metastasis and recurrence of liver cancer. Methods: the data of 116 cases of postoperative metastasis and recurrence of primary liver cancer were retrospectively analyzed. All the patients were confirmed to be hepatocellular carcinoma by operation or biopsy and pathology. The serum levels of AFP, AFP-L3, CA125, CEA and CEA were detected by chemiluminescence assay. The AFP values were 1210 ng / L, and all patients underwent MRI routine scan and DWI scan. Results: the sensitivity and specificity of CEA in peripheral blood serum tumor marker AFP-L3 + CA1999 CA125G increased with the enlargement of tumor. The sensitivity of combined detection of four tumor markers and the diagnostic sensitivity of combined detection of four tumor markers with highest specificity. DWI was the highest. The specificity can be increased to 98.4 and 95.0.Conclusion the detection of tumor markers combined with WDWI is effective in monitoring the metastasis and recurrence of liver cancer, which provides a new way to evaluate the curative effect and follow up the tumor after operation.
【学位授予单位】：山东大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R735.7;R445.2

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