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目的探讨外周血调节活化正常T细胞分泌与表达因子(regulated upon activation normal T cell expressed and secreted,RANTES)对乙肝病毒相关的肝细胞癌(HCC)的诊断价值。方法选择北京佑安医院2010年2月至2011年11月收治的慢性乙型肝炎患者35例、乙型肝炎肝硬化患者34例及乙肝病毒相关HCC患者47例。Luminex技术检测外周血清中趋化性细胞因子RANTES水平。结果HCC患者外周血RANTES水平[(23.27±21.16)ng/ml]明显高于慢性乙型肝炎[(7.81±4.06)ng/ml]及乙肝肝硬化患者[(5.36±6.13)ng/ml],3组比较差异有统计学意义(P<0.001)。HCCⅡ期患者外周血RANTES水平明显高于Ⅰ期患者,差异有统计学意义[(31.94±25.94)ng/ml vs.(14.24±8.10)ng/ml,P=0.004]。RANTES预测慢性乙型肝炎、乙肝肝硬化进展为HCC的阈值为7.85 ng/ml,敏感性为93.5%,特异性为72.5%。结论 HCC患者外周血中趋化因子RANTES水平明显增高,且HCCⅡ期患者RANTES水平明显高于Ⅰ期患者,可作为乙肝病毒相关HCC诊断及病情评估的参考指标。
Objective To investigate the value of regulated on activation normal T cell expressed and secreted (RANTES) in the diagnosis of hepatitis B virus-related hepatocellular carcinoma (HCC). Methods Thirty-five patients with chronic hepatitis B, 34 patients with hepatitis B cirrhosis, and 47 patients with hepatitis B virus-associated HCC were selected from February 2010 to November 2011 in Beijing You’an Hospital. The Luminex technique measures peripheral chemokine RANTES levels in serum. Results The RANTES level in peripheral blood of patients with HCC was significantly higher than that in patients with chronic hepatitis B (7.81±4.06 ng/ml) and patients with hepatitis B cirrhosis[(5.36±6.13) ng/ml]. The difference between the three groups was statistically significant (P<0.001). The level of RANTES in peripheral blood of patients with stage HCC was significantly higher than that of patients with stage I. The difference was statistically significant [(31.94±25.94) ng/ml vs. (14.24±8.10) ng/ml, P=0.004]. RANTES predicts that the threshold for the progression of chronic hepatitis B and hepatitis B cirrhosis to HCC is 7.85 ng/ml, with a sensitivity of 93.5% and a specificity of 72.5%. Conclusions The level of chemokine RANTES in peripheral blood of patients with HCC is significantly higher, and the level of RANTES in patients with HCC II is significantly higher than that in patients with stage I. It can be used as a reference index for the diagnosis and evaluation of HCC-associated HCC.