论文部分内容阅读
目的探讨血清RASSF1A启动子甲基化可能作为一种新的肝细胞癌(HCC)标志物在无创性诊断中的价值。方法Methy Light法测定190例HCC、114例肝硬化(LC)、120例慢性乙型病毒性肝炎(CHB)患者和160例健康对照者血清RASSF1A甲基化,结果用甲基化比值(PMR)表示,PMR≥4为阳性。结果 HCC、LC、CHB患者血清RASSF1A甲基化阳性率分别为64.2%(122/190)、17.5%(20/114)、5.0%(6/120),健康体检者未检出,阳性率差异均有统计学意义(P<0.01)。RASSF1A甲基化阳性时,其从CHB中鉴别HCC的敏感度为64.2%,特异度为89.8%,AUCRASSF1A=0.796(95%CI为0.746~0.842);RASSF1A甲基化联合AFP(≥20 ng/L),其敏感度为80.9%,特异度为93.4%,AUCRASSF1A+AFP=0.876(95%CI为0.836~0.917)。RASSF1A甲基化阳性与HCC组织学分级、TNM分期及远端转移相关(P<0.05),与其他临床病理特点无关。结论血清RASSF1A启动子甲基化对HBV相关的HCC可能具有较高的诊断价值,同时可预测HCC临床进展。
Objective To investigate the value of serum RASSF1A promoter methylation as a new marker of hepatocellular carcinoma (HCC) in noninvasive diagnosis. Methods The methylation of RASSF1A in 190 cases of HCC, 114 cases of cirrhosis (LC), 120 cases of chronic hepatitis B (CHB) and 160 healthy controls was detected by Methy Light. The methylation ratio (PMR) Said PMR ≥ 4 is positive. Results The positive rates of RASSF1A methylation in patients with HCC, LC and CHB were 64.2% (122/190), 17.5% (20/114) and 5.0% (6/120), respectively. The positive rate of RASSF1A was not detected in healthy subjects All were statistically significant (P <0.01). The sensitivity and specificity of RASSF1A methylation were 64.2%, 89.8%, AUCRASSF1A = 0.796 (95% CI: 0.746-0.842), respectively. The RASSF1A methylation combined with AFP (≥20 ng / L), the sensitivity was 80.9%, the specificity was 93.4%, AUCRASSF1A + AFP = 0.876 (95% CI 0.836 ~ 0.917). RASSF1A methylation positive correlation with HCC histological grade, TNM stage and distant metastasis (P <0.05), and has nothing to do with other clinicopathological features. Conclusion Serum RASSF1A promoter methylation may have high diagnostic value for HBV-related HCC, and can predict the clinical progress of HCC.