本文關(guān)鍵詞： 肝細(xì)胞肝癌 EGFL7 OPN PGE2 肝細(xì)胞肝癌 腫瘤標(biāo)記 生物學(xué) 轉(zhuǎn)移復(fù)發(fā) 磁共振成像　出處：《山東大學(xué)》2014年博士論文　論文類型：學(xué)位論文

【摘要】：第一部分EGFL7、OPN和PGE2的表達(dá)與肝細(xì)胞肝癌復(fù)發(fā)轉(zhuǎn)移的相關(guān)性研究 目的：在肝癌患者,腫瘤侵襲、轉(zhuǎn)移和復(fù)發(fā)是造成死亡最常見(jiàn)的原因,因此與肝癌治療和預(yù)后判斷相關(guān)的因子非常重要。通常臨床上診斷肝癌最常用的血清學(xué)標(biāo)志物是甲胎蛋白AFP和一些特定的肝臟的酶類,當(dāng)然還有體格檢查和影像學(xué)技術(shù)的輔助。良好的的血清標(biāo)志物具有方便篩選和早期診斷的作用,能顯著的改善預(yù)后。 方法：我們開(kāi)展了一項(xiàng)回顧性隊(duì)列研究,分析了90例具有單個(gè)或者多點(diǎn)肝癌的肝硬化患者。我們采用ELISA的方法檢測(cè)了他們EGFL7, OPN和PGE2的水平。 結(jié)果：在肝癌患者這些因子的水平與健康人相比具有顯著的不同。在肝細(xì)胞肝癌患者患者EGFL7, OPN和PGE2的水平分別為：132.11pg/L,11.77ng/mL,,179.37pg/mL,這些數(shù)據(jù)顯著的高于健康志愿者EGFL7, OPN和PGE2的的水平,分別為：23.03pg/mL,2.31ng/mL,47.36pg/mL。 結(jié)論：EGFL7, OPN和PGE2可以用來(lái)篩選和監(jiān)控高危人群中肝癌的發(fā)生,并且會(huì)改善這些患者的預(yù)后。 第二部分DWI聯(lián)合外周血清腫瘤標(biāo)志物對(duì)肝癌術(shù)后轉(zhuǎn)移復(fù)發(fā)早期診斷的價(jià)值 目的：探討DWI聯(lián)合外周血清腫瘤標(biāo)志物指標(biāo)對(duì)肝癌術(shù)后轉(zhuǎn)移復(fù)發(fā)早期診斷的價(jià)值。 方法：回顧分析116例原發(fā)性肝癌術(shù)后轉(zhuǎn)移復(fù)發(fā)的病歷資料,所有患者均經(jīng)手術(shù)或者穿刺活檢病理證實(shí)確診為肝癌�；颊呔谢瘜W(xué)發(fā)光法檢測(cè)血清甲胎蛋白(AFP)、甲胎蛋白異質(zhì)體3(AFP-L3)、癌相關(guān)抗原(CA125、CA199)、癌胚抗原(CEA)水平,其中AFP值均1210ng/L,所有患者均行MRI常規(guī)掃描和DWI掃描。 結(jié)果：外周血血清腫瘤標(biāo)志物AFP-L3、CA199、CA125、CEA靈敏度及特異度隨腫塊增大而升高,4項(xiàng)腫瘤標(biāo)志物聯(lián)合檢測(cè)的敏感度及特異度最高。DWI聯(lián)合4項(xiàng)腫瘤標(biāo)志物檢測(cè)的診斷敏感度、特異度可提高到98.4和95.0%。結(jié)論：DWI聯(lián)合腫瘤標(biāo)志物檢測(cè)對(duì)肝癌術(shù)后轉(zhuǎn)移復(fù)發(fā)監(jiān)測(cè)敏感有效,為腫瘤術(shù)后評(píng)估療效和追蹤復(fù)查提供一條新途徑。
[Abstract]:The relationship between the expression of EGFL7 and PGE2 and the recurrence and Metastasis of Hepatocellular carcinoma. Objective: in patients with liver cancer, invasion, metastasis and recurrence are the most common causes of death. Therefore, the factors related to the treatment and prognosis of HCC are very important. The most commonly used serological markers in clinical diagnosis of HCC are alpha-fetoprotein AFP and some specific liver enzymes. Of course, there are physical examination and imaging techniques. Good serum markers can be used for screening and early diagnosis, and can significantly improve prognosis. Methods: a retrospective cohort study was conducted to analyze 90 patients with liver cirrhosis with single or multiple liver cancer. The levels of EGFL7, OPN and PGE2 were measured by ELISA. Results: the levels of EGFL7, OPN and PGE2 in HCC patients were significantly different from those in healthy controls. The levels of EGFL7, OPN and PGE2 in HCC patients were 1: 132.11pg / L 11.77ng / mL, 179.37pg / mLrespectively, which were significantly higher than those in healthy volunteers (EGFL7, OPN and PGE2). They are:: 23.03 PG / mL 2.31 ng / mL 47.36 PG / mL. Conclusion OPN, OPN and PGE2 can be used to screen and monitor the occurrence of liver cancer in high risk population and improve the prognosis of these patients. The value of DWI combined with peripheral blood tumor markers in the early diagnosis of postoperative metastasis and recurrence of hepatocellular carcinoma. Objective: to investigate the value of DWI combined with peripheral blood tumor markers in the early diagnosis of postoperative metastasis and recurrence of liver cancer. Methods: the data of 116 cases of postoperative metastasis and recurrence of primary liver cancer were retrospectively analyzed. All the patients were confirmed to be hepatocellular carcinoma by operation or biopsy and pathology. The serum levels of AFP, AFP-L3, CA125, CEA and CEA were detected by chemiluminescence assay. The AFP values were 1210 ng / L, and all patients underwent MRI routine scan and DWI scan. Results: the sensitivity and specificity of CEA in peripheral blood serum tumor marker AFP-L3 + CA1999 CA125G increased with the enlargement of tumor. The sensitivity of combined detection of four tumor markers and the diagnostic sensitivity of combined detection of four tumor markers with highest specificity. DWI was the highest. The specificity can be increased to 98.4 and 95.0.Conclusion the detection of tumor markers combined with WDWI is effective in monitoring the metastasis and recurrence of liver cancer, which provides a new way to evaluate the curative effect and follow up the tumor after operation.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R735.7;R445.2

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