肝脏MRI联合血清DKK1、GPC3、FOXP3、CXCL13和AFP检测诊断肝细胞癌价值分析

肝脏 ›› 2020, Vol. 25 ›› Issue (12): 1282-1285.

肝脏MRI联合血清DKK1、GPC3、FOXP3、CXCL13和AFP检测诊断肝细胞癌价值分析

冯硕, 昝立山, 马军, 李凡, 贾建伟, 李增军

100020 北京朝阳医院放射科(冯硕,昝立山,马军,李凡,贾建伟);山东省肿瘤医院普外科(李增军)

收稿日期:2019-10-20 出版日期:2020-12-31 发布日期:2021-02-26
基金资助:
山东省科技发展计划项目(gsf11834)

The value of liver magnetic resonance imaging in combination with serum biomarkers for the diagnosis of hepatocellular carcinoma

FENG Shuo, ZAN Li-shan, MA Jun, LI Fan, JIA Jian-wei, LI Zeng-jun

Department of Radiology, Chaoyang Hospital, Beijing 100020, China

Received:2019-10-20 Online:2020-12-31 Published:2021-02-26

摘要/Abstract

摘要： 目的探究MRI技术联合检测血清DKK1、GPC3、FOXP3、CXCL13及AFP在肝细胞癌(HCC)患者中的诊断价值。方法选取2017年1月至2018年6月,北京朝阳医院住院HCC患者80例为肝癌组,肝硬化以及健康体检者各60例为良性肝病组和对照组。各组纳入患者均行MRI检查,并采用ELISA法测定血清DKK1、GPC3、FOXP3 、CXCL13、AFP。计算并比较各指标的阳性率、灵敏度、特异性。结果血清中四种标志物含量比较,肝癌组和良性肝病组均高于健康人,肝癌组高于良性肝病组(P<0.05)。MRI技术及血清DKK1、GPC3、FOXP3、CXCL13肝癌诊断的灵敏度分别为88.8%、95.0%、91.3%、85.0%、93.7%,特异性分别为76.7%、85.0%、80.0%、71.7%、81.7%,且均高于AFP的[(81.3%,56.7%),P<0.05)]。结论 MRI技术联合血清DKK1、GPC3、FOXP3、CXCL13可以提高对HCC的检出率,具有较高的临床应用价值。

关键词: 肝癌联合诊断, MRI, 人磷脂酰肌醇蛋白聚糖3, 转录因子FOXP3

Abstract: Objective To explore the diagnostic value of combining Magnetic Resonance Imaging (MRI) with serum levels of Dikkopf-1(DKK1), glypican-3(GPC3), FOXP3 and CXCL13 for patients with hepatocellular carcinoma(HCC).Methods Eighty hospitalized patients with HCC aged 30-75 were selected in HCC group. Sixty patients with chronic hepatitis and cirrhosis were enrolled as chronic liver diseases (CLD) group. Sixty healthy people were enrolled in the control group. All patients in the three groups were examined by MRI, and detected with serum levels of DKK1, GPC3, FOXP3, CXCL13, and AFP by enzyme linked immunosorbent assay (ELISA). The positive rate, sensitivity and specificity of each parameters were calculated and compared.Results The serum levels of four biomarkers in HCC group and CLD group were higher than those in the control group, and the levels in HCC group were higher than those in the CLD group (P<0.05). The sensitivity of MRI and serum levels of DKK1, GPC3, FOXP3 and CXCL13 for the diagnosis of HCC were 88.8%,95.0%,91.3%,85.0%,93.7%,respectively,and all were higher than 80%. The specificity of them were 76.7%,85.0%,80.0%,71.7%,81.7%,respectively, and all were higher than 70%. Among them, the sensitivity and specificity of DK1 were the highest (95.0% and 85.0%,respectively). The sensitivity and specificity of AFP (81.3% and 56.7%, respectively)for the diagnosis of HCC were lower when compared with these biomarkers.Conclusion MRI in combination with serum detection of DKK1, GPC3, FOXP3 and CXCL13 may improve the detection rate of HCC, and has a high clinical application value.

Key words: Hepatocellular carcinoma, Diagnosis, Magnetic Resonance Imaging, Serum biomarkers

冯硕, 昝立山, 马军, 李凡, 贾建伟, 李增军. 肝脏MRI联合血清DKK1、GPC3、FOXP3、CXCL13和AFP检测诊断肝细胞癌价值分析[J]. 肝脏, 2020, 25(12): 1282-1285.

FENG Shuo, ZAN Li-shan, MA Jun, LI Fan, JIA Jian-wei, LI Zeng-jun. The value of liver magnetic resonance imaging in combination with serum biomarkers for the diagnosis of hepatocellular carcinoma[J]. Chinese Hepatolgy, 2020, 25(12): 1282-1285.

参考文献

[1] Huaman J, Bach C, Ilboudo A, et al. Epithelial-to-mesenchymal transition in hepatocellular carcinoma . Future Oncol, 2018, 5:1169-1171.
[2] Tajul Arifin, Khaizurin, Sulaiman, et al. Elevation of tumour markers TGF-β, M2-PK, OV-6 and AFP in hepatocellular carcinoma (HCC)-induced rats and their suppression by microalgae Chlorella vulgaris. BMC Cancer, 2017, 17:879-881.
[3] Kurucay M, Kloth C, Kaufmann S, et al. Multiparametric imaging for detection and characterization of hepatocellular carcinoma using gadoxetic acid-enhanced MRI and perfusion-CT: which parameters work best .Cancer Imaging, 2017, 17:18-21.
[4] Lim T S, Kim D Y, Han K H, et al. Combined use of AFP, PIVKA-II, and AFP-L3 as tumor markers enhances diagnostic accuracy for hepatocellular carcinoma in cirrhotic patients. Scand J Gastroenterol, 2016, 51:344-346.
[5] Alexandros G, Giakoustidis Dimitrios, Mudan Satvinder, et al. Molecular signalling in hepatocellular carcinoma: role of and crosstalk among wnt/β-catenin, sonic hedgehog, notch and dickkopf-1. Can J Gastroenterol Hepatol, 2016, 29:209-217.
[6] 高杰, 朱继业. 卫生部《原发性肝癌诊疗规范(2011年版)》解读.中华普通外科杂志,2012, 27:693-695.
[7] Kachler K, Holzinger C, Trufa D I, et al. The role of foxp3 and tbet co-expressing treg cells in lung carcinoma. OncoImmunology, 2018, 7:104-106.
[8] Gutrantien C. Cxcl13-producing TFH cells link immune suppression and adaptive memory in human breast cancer. JCI Insight, 2017, 2:163-167.
[9] 党珊, 陈谱, 张冰斐, 等. 叉头样转录因子3的表达及其甲基化状态在肝细胞性肝癌患者中的研究 . 中华肝脏病杂志, 2014, 22:616-619.
[10] Kalinich M, Bhan, Irun, et al. An RNA-based signature enables high specificity detection of circulating tumor cells in hepatocellular carcinoma . Proc Natl Acad Sci U S A, 2017, 114:1123-1128.
[11] Ramalho M, Matos A P, Alobaidy M, et al. Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment-Part 2 . Radiol Bras, 2017, 50:38-47.
[12] Ooka Y, Kanai F, Okabe S, et al. Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma . Magn Reson Imaging, 2013, 31:748-754.
[13] Mazzaferro V, Busset M D D, Bhoori S. Alpha‐fetoprotein in liver transplantation for hepatocellular carcinoma: the lower, the better . Hepatology, 2018. 26:153-156.
[14] Tung E, Mak C, Lee J, et al. Serum level of DKK1 as a marker for predicting tumor recurrence of hepatocellular carcinoma. Cancer Res, 2010, 70(8 Supplement):1779-1779.

[1]	张海军, 张宏娟. 基于静息态fMRI影像学研究轻微肝性脑病患者双侧楔前叶与全脑连接的变化[J]. 肝脏, 2020, 25(7): 732-735.
[2]	陆舜钦, 李彦, 管竹春, 何丽娟. CT/MRI融合图像在肝癌介入治疗术后疗效评估中的应用[J]. 肝脏, 2020, 25(7): 768-769.
[3]	薛志伟, 王伟. Gd-BOPTA肝脏DFCE-MRI与常规MRI在HCC诊断中的对比研究[J]. 肝脏, 2020, 25(3): 306-307.
[4]	刘冬, 李义, 曾庆. MRI T2WI图像纹理参数判断肝细胞癌微血管侵犯的价值[J]. 肝脏, 2020, 25(12): 1275-1277.
[5]	马臻雏, 蒋兆杰. 基于CT和MRI检查肝脏成像报告和数据系统评判肝结节性质临床应用[J]. 肝脏, 2020, 25(10): 1062-1064.
[6]	冯文秋, 迟红卫, 陈艳芳. 钆塞酸增强MRI对诊断小肝癌及其鉴别诊断的临床意义和应用价值[J]. 肝脏, 2019, 24(9): 1037-1040.
[7]	周宇, 穆燕雪, 欧园, 杜明珊, 唐雪松. Gd-EOB-MRI技术用于慢性肝病伴肝脏结节恶性转化风险判断的价值[J]. 肝脏, 2019, 24(7): 808-810.
[8]	张成成, 唐小琦, 张志国, 郑于平. MRI多期动态对比增强灌注参数与肝癌微血管密度的相关性[J]. 肝脏, 2019, 24(4): 428-431.
[9]	史芳芳, 郑增, 任洪伟, 安维民, 董景辉. 肝脏神经内分泌癌的CT及MRI特征[J]. 肝脏, 2019, 24(2): 143-146.
[10]	郑晓东, 唐亮. CT和MRI增强扫描对肝脏局灶性结节性增生的诊断价值[J]. 肝脏, 2019, 24(12): 1468-1470.
[11]	武文辉, 崔立春, 党升强, 王剑. HBV相关性肝癌患者血清B7-H3、IL-21水平及MRI影像学变化与患者病情严重程度的关系[J]. 肝脏, 2019, 24(11): 1251-1254.
[12]	孔凡豹, 刘婷. 小肝癌微波消融术后疗效的CT及MRI随访对照研究[J]. 肝脏, 2018, 23(2): 157-159.
[13]	吕国义. MRI与CT诊断肝血管平滑肌脂肪瘤的价值及影像表现[J]. 肝脏, 2018, 23(1): 62-65.
[14]	叶文宏, 汪苍, 方佃刚, 干芸根. CT及MRI诊断小儿肝脏肿瘤的临床应用价值[J]. 肝脏, 2016, 21(6): 477-480.
[15]	李明通. MRI检查及ADC值对肝腺瘤诊断的意义[J]. 肝脏, 2016, 21(3): 176-178.