细胞角蛋白-19、CA50联合甲胎蛋白对肝细胞癌的疾病进展评估价值

摘要/Abstract

摘要： 目的探讨细胞角蛋白-19(CK-19)、癌胚抗原50(CA50)与甲胎蛋白(AFP)在肝细胞癌患者中的表达情况,以及上述生物标志物在疾病进展评估中的应用价值。方法选取2021年2月—2024年2月期间常州市武进中医医院收治的89例肝细胞癌患者作为研究对象纳入肝细胞癌组,将同期住院治疗的33例肝良性结节组患者纳入良性结节组,并设立50例健康成人作为参照组。通过测定不同组别CK-19、CA50和AFP的表达水平,并分析其与TNM分期的相关性。通过ROC曲线评估CK-19、CA50和AFP在疾病进展评估中的应用效果。结果肝细胞癌组的血清CK-19水平为(18.96±5.20)ng/mL、CA50水平为(31.54±8.60)U/mL、AFP水平为(310.16±63.14)U/L,均高于良性结节组和参照组。良性结节组的CK-19水平为(5.84±0.79)ng/mL、CA50水平为(15.15±3.47)U/mL、AFP水平为(78.26±23.58)U/L。参照组的CK-19水平为(2.61±0.35)ng/mL、CA50水平为(7.08±1.86)U/mL、AFP水平为(41.02±9.72)U/L(P<0.05)。Ⅰ期组、Ⅱ期组、Ⅲ期组、Ⅳ期组患者的血清CK-19、CA50、AFP水平变化趋势为Ⅳ期组＞Ⅲ期组＞Ⅱ期组＞Ⅰ期组(P<0.05)。采用Spearman相关性分析,疾病进展程度与血清CK-19、CA50、AFP水平存在正相关(r=0.649、0.452、0.408;P均＜0.05)。ROC曲线分析表明,CK-19、CA50和AFP联合预测肝细胞癌疾病进展具有较高的诊断价值,AUC值为0.872,灵敏度为80.8%,特异度为81.1%。结论 CK-19、CA50和AFP的表达水平与肝细胞癌的疾病进展密切相关,可作为评估病情进展的有效生物标志物。

关键词: 细胞角蛋白-19, 癌胚抗原50, 甲胎蛋白, 肝细胞癌, 生物标志物

Abstract: Objective To investigate the expression levels of cytokeratin-19 (CK-19), carbohydrate antigen 50 (CA50), and alpha-fetoprotein (AFP) in patients with hepatocellular carcinoma, and to assess the utility of these biomarkers in evaluating disease progression. Methods A total of 89 patients diagnosed with hepatocellular carcinoma at Wujin Hospital of Traditional Chinese Medicine in Changzhou from February 2021 to February 2024 were included in the hepatocellular carcinoma group. Additionally, 33 patients with benign liver nodules treated during the same period were included in the benign nodule group, and 50 healthy adults served as the control group. The expression levels of CK-19, CA50, and AFP were measured, and their correlation with TNM staging was analyzed. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic efficacy of these biomarkers in tracking disease progression. Methods Serum levels of CK-19, CA50, and AFP were significantly higher in the hepatocellular carcinoma group (18.96±5.20 ng/mL, 31.54±8.60 U/mL, and 310.16±63.14 U/L, respectively) compared to the benign nodule group (5.84±0.79 ng/mL, 15.15±3.47 U/mL, 78.26±23.58 U/L) and the reference group (2.61±0.35 ng/mL, 7.08±1.86 U/mL, 41.02±9.72 U/L; P<0.05). A trend of increasing biomarker levels from stage I to IV was observed (P<0.05). Spearman's correlation analysis showed a positive correlation between disease progression and serum levels of CK-19, CA50, and AFP (r=0.649, 0.452, 0.408; all P<0.05). The combined predictive performance of CK-19, CA50, and AFP for disease progression in hepatocellular carcinoma was high, with an AUC of 0.872, sensitivity of 80.8%, and specificity of 81.1%. Conclusion The expression levels of CK-19, CA50, and AFP are closely related to the progression of hepatocellular carcinoma and can serve as effective biomarkers for assessing disease progression.

Key words: CK-19, CA50, AFP, Hepatocellular carcinoma, Biomarkers

蒋程程, 董鑫园. 细胞角蛋白-19、CA50联合甲胎蛋白对肝细胞癌的疾病进展评估价值[J]. 肝脏, 2025, 30(1): 50-54.

JIANG Cheng-cheng, DONG Xin-yuan. The value of cytokeratin-19, CA50, and alpha-fetoprotein in assessing disease progression in hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(1): 50-54.

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