RNA结合基序蛋白8A对原发性肝癌的诊断价值研究

发布时间：2018-02-26 09:43

  本文关键词： 肝癌 RNA结合基序蛋白8A 甲胎蛋白 诊断　出处：《广西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：研究RNA结合基序蛋白8A (RNA-binding motif protein 8A, RBM8A)在原发性肝癌患者血清中的表达及其诊断价值。方法：收集原发性肝癌、肝硬化、其他恶性肿瘤患者及健康体检者的血清及相关临床资料。应用双抗体夹心酶联免疫定量测定方法(enzyme-linked immunosorbent assay, ELISA)检测各组血清中RBM8A水平,各组血清AFP(Alpha fetoprotein)浓度均由检验科电化学发光法测得,分析RBM8A表达及其对肝癌的诊断价值。结果：1、本研究共收集外周血清340例,包括原发性肝癌患者110例,肝硬化患者55例,其他恶性肿瘤患者87例和健康体检者88例。2、肝癌组RBM8A表达水平显著高于肝硬化组、其他恶性肿瘤组及健康体检者组(分别为2.271+1.730,0.381士0.121,1.307±1.003,0.255±0.067,P0.05),表达结果差异具有统计学意义。在肝癌组中AFP表达水平在不同肿瘤大小组间(分别为≤3cm、3cm并≤10cm和10cm)差异具有统计学意义(P0.05),且AFP表达水平随着肿瘤大小的增大而升高；而RBM8A表达水平在不同肿瘤大小组间差异不具有统计学意义(P0.05)。3、通过受试者工作特征(receiver operating characteristic, ROC)曲线得出RBM8A的cut off值为1.002ng/mL, RBM8A诊断肝癌的灵敏度和特异度分别为80.0%和84.2%；AFP的cut off值为33.275ng/mL,其对应的灵敏度(70.0%)显著低于于RBM8A,特异度(94.8%)高于RBM8A, P 0.05; RBM8A和AFP曲线下面积分别为0.881和0.865(P0.05)。4、肝癌组有34例患者AFP≤33.275ng/mL,其中55.9%(19/34)的患者RBM8A1.002ng/mL。5、联合检测RBM8A和AFP诊断肝癌的灵敏度和特异度分别为86.3%和82.6%,与单用RBM8A或AFP检测相比提高了灵敏度(P0.05),阴性预测值达92.4%,Youden指数提高到0.689。6、相关性分析结果表明肝癌组、肝硬化组、健康体检组RBM8A与AFP具有相关性；而在其他恶性肿瘤组RBM8A与AFP无相关性。结论：1、RBM8A在肝癌患者血清中的表达水平较肝硬化、其他恶性肿瘤患者及健康人高。2、RBM8A可作为一种新的诊断肝癌的血清标记物,可提高血清AFP阴性肝癌患者的诊断率。3、联合检测血清RBM8A和AFP可以有效提高AFP呈现低浓度或AFP表现为阴性的肝癌患者的诊断价值,两者联合提高了肝癌的检出率,为肝癌诊断提供更有效的检测方法。
[Abstract]:Objective: to study the expression and diagnostic value of RNA binding motif protein 8A RNA-binding motif protein 8A (RBM8A) in the serum of patients with primary liver cancer. Serum and related clinical data of patients with other malignant tumors and healthy persons. The serum RBM8A level was detected by enzyme linked immunosorbent assay (Elisa) with double antibody sandwich enzyme linked immunosorbent assay (Elisa). The concentration of serum AFP(Alpha fetoprotein in each group was determined by electrochemiluminescence method. The expression of RBM8A and its diagnostic value in HCC were analyzed. Results: 1. The peripheral blood samples were collected from 340 patients, including 110 patients with primary liver cancer and 55 patients with liver cirrhosis. The expression of RBM8A in liver cancer group was significantly higher than that in cirrhosis group. Other malignant tumor groups and healthy persons (2.271 1.730 + 0.381 卤0.121 卤1.307 卤1.003 卤0.255 卤0.067 P0.05) showed significant difference in the expression of AFP. There were significant differences in the expression of AFP between different tumor groups (鈮，

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