發(fā)布時間：2018-02-11 05:57

  本文關鍵詞： 肝細胞肝癌 EGFL7 OPN PGE2 肝細胞肝癌 腫瘤標記 生物學 轉移復發(fā) 磁共振成像　出處：《山東大學》2014年博士論文　論文類型：學位論文

【摘要】：第一部分EGFL7、OPN和PGE2的表達與肝細胞肝癌復發(fā)轉移的相關性研究 目的：在肝癌患者,腫瘤侵襲、轉移和復發(fā)是造成死亡最常見的原因,因此與肝癌治療和預后判斷相關的因子非常重要。通常臨床上診斷肝癌最常用的血清學標志物是甲胎蛋白AFP和一些特定的肝臟的酶類,當然還有體格檢查和影像學技術的輔助。良好的的血清標志物具有方便篩選和早期診斷的作用,能顯著的改善預后。 方法：我們開展了一項回顧性隊列研究,分析了90例具有單個或者多點肝癌的肝硬化患者。我們采用ELISA的方法檢測了他們EGFL7, OPN和PGE2的水平。 結果：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,這些數據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。 結論：EGFL7, OPN和PGE2可以用來篩選和監(jiān)控高危人群中肝癌的發(fā)生,并且會改善這些患者的預后。 第二部分DWI聯合外周血清腫瘤標志物對肝癌術后轉移復發(fā)早期診斷的價值 目的：探討DWI聯合外周血清腫瘤標志物指標對肝癌術后轉移復發(fā)早期診斷的價值。 方法：回顧分析116例原發(fā)性肝癌術后轉移復發(fā)的病歷資料,所有患者均經手術或者穿刺活檢病理證實確診為肝癌。患者均行化學發(fā)光法檢測血清甲胎蛋白(AFP)、甲胎蛋白異質體3(AFP-L3)、癌相關抗原(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。 結果：外周血血清腫瘤標志物AFP-L3、CA199、CA125、CEA靈敏度及特異度隨腫塊增大而升高,4項腫瘤標志物聯合檢測的敏感度及特異度最高。DWI聯合4項腫瘤標志物檢測的診斷敏感度、特異度可提高到98.4和95.0%。結論：DWI聯合腫瘤標志物檢測對肝癌術后轉移復發(fā)監(jiān)測敏感有效,為腫瘤術后評估療效和追蹤復查提供一條新途徑。
[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.
【學位授予單位】：山東大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R735.7;R445.2

【參考文獻】

相關期刊論文 前10條

1 鄭建剛;許建興;梅莉;顧勇堅;;DWI中不同b值對肝臟小病灶診斷價值的探討[J];中國CT和MRI雜志;2009年05期

2 程華才;陳家祥;馬巖;潘豫節(jié);張宏偉;;彌散加權成像在肝臟局灶性病變中的應用[J];中國CT和MRI雜志;2011年02期

3 胡敏華;陳燕;黃建英;;肝癌患者癌胚抗原檢測的臨床意義[J];國際檢驗醫(yī)學雜志;2006年01期

4 A. Andreou;D.M. Koh;D.J. Col lins;M. Black ledge;T. Wallace;M.O. Leach;郭凌飛;;正常肝臟和肝轉移瘤的體素內非相干性運動(IVIM)擴散加權成像中灌注分數與準擴散系數的可重復性測量[J];國際醫(yī)學放射學雜志;2013年02期

5 李耀軍;文凌娟;;腫瘤標記物在不同病理類型肺癌中表達意義[J];中華實用診斷與治療雜志;2011年02期

6 班副植;農世澤;黃承樂;黎榮能;;原發(fā)性肝癌患者血清甲胎蛋白和a-L-巖藻糖苷酶聯合檢測的臨床價值[J];檢驗醫(yī)學與臨床;2009年10期

7 閆新成;楊廣夫;劉暉;何濱;韓博;李金柱;富憲民;姚曉群;楊小軍;張保其;張文奎;;MR擴散加權成像在肝臟占位性病變中的應用[J];實用放射學雜志;2008年08期

8 呂梁;霍繼榮;彭紅軍;王芳;;原發(fā)性肝癌患者治療前后甲胎蛋白的變化[J];臨床和實驗醫(yī)學雜志;2008年08期

9 王遠;;AFP、CEA、CA-199聯合檢測在原發(fā)性肝癌診斷中的應用價值[J];齊齊哈爾醫(yī)學院學報;2013年06期

10 錢海峰;胡春洪;祝躍明;沈小勇;李鳳琪;;擴散加權成像對局灶性肝癌血供分析的診斷價值[J];醫(yī)學影像學雜志;2012年05期

，

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