本文關(guān)鍵詞： 肝癌 RNA結(jié)合基序蛋白8A 甲胎蛋白 診斷　出處：《廣西醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：研究RNA結(jié)合基序蛋白8A (RNA-binding motif protein 8A, RBM8A)在原發(fā)性肝癌患者血清中的表達(dá)及其診斷價(jià)值。方法：收集原發(fā)性肝癌、肝硬化、其他惡性腫瘤患者及健康體檢者的血清及相關(guān)臨床資料。應(yīng)用雙抗體夾心酶聯(lián)免疫定量測(cè)定方法(enzyme-linked immunosorbent assay, ELISA)檢測(cè)各組血清中RBM8A水平,各組血清AFP(Alpha fetoprotein)濃度均由檢驗(yàn)科電化學(xué)發(fā)光法測(cè)得,分析RBM8A表達(dá)及其對(duì)肝癌的診斷價(jià)值。結(jié)果：1、本研究共收集外周血清340例,包括原發(fā)性肝癌患者110例,肝硬化患者55例,其他惡性腫瘤患者87例和健康體檢者88例。2、肝癌組RBM8A表達(dá)水平顯著高于肝硬化組、其他惡性腫瘤組及健康體檢者組(分別為2.271+1.730,0.381士0.121,1.307±1.003,0.255±0.067,P0.05),表達(dá)結(jié)果差異具有統(tǒng)計(jì)學(xué)意義。在肝癌組中AFP表達(dá)水平在不同腫瘤大小組間(分別為≤3cm、3cm并≤10cm和10cm)差異具有統(tǒng)計(jì)學(xué)意義(P0.05),且AFP表達(dá)水平隨著腫瘤大小的增大而升高；而RBM8A表達(dá)水平在不同腫瘤大小組間差異不具有統(tǒng)計(jì)學(xué)意義(P0.05)。3、通過(guò)受試者工作特征(receiver operating characteristic, ROC)曲線得出RBM8A的cut off值為1.002ng/mL, RBM8A診斷肝癌的靈敏度和特異度分別為80.0%和84.2%；AFP的cut off值為33.275ng/mL,其對(duì)應(yīng)的靈敏度(70.0%)顯著低于于RBM8A,特異度(94.8%)高于RBM8A, P 0.05; RBM8A和AFP曲線下面積分別為0.881和0.865(P0.05)。4、肝癌組有34例患者AFP≤33.275ng/mL,其中55.9%(19/34)的患者RBM8A1.002ng/mL。5、聯(lián)合檢測(cè)RBM8A和AFP診斷肝癌的靈敏度和特異度分別為86.3%和82.6%,與單用RBM8A或AFP檢測(cè)相比提高了靈敏度(P0.05),陰性預(yù)測(cè)值達(dá)92.4%,Youden指數(shù)提高到0.689。6、相關(guān)性分析結(jié)果表明肝癌組、肝硬化組、健康體檢組RBM8A與AFP具有相關(guān)性；而在其他惡性腫瘤組RBM8A與AFP無(wú)相關(guān)性。結(jié)論：1、RBM8A在肝癌患者血清中的表達(dá)水平較肝硬化、其他惡性腫瘤患者及健康人高。2、RBM8A可作為一種新的診斷肝癌的血清標(biāo)記物,可提高血清AFP陰性肝癌患者的診斷率。3、聯(lián)合檢測(cè)血清RBM8A和AFP可以有效提高AFP呈現(xiàn)低濃度或AFP表現(xiàn)為陰性的肝癌患者的診斷價(jià)值,兩者聯(lián)合提高了肝癌的檢出率,為肝癌診斷提供更有效的檢測(cè)方法。
[Abstract]:Objective: to study the expression and diagnostic value of RNA binding motif protein 8A RNA-binding motif protein 8A (RBM8A) in the serum of patients with primary liver cancer. Serum and related clinical data of patients with other malignant tumors and healthy persons. The serum RBM8A level was detected by enzyme linked immunosorbent assay (Elisa) with double antibody sandwich enzyme linked immunosorbent assay (Elisa). The concentration of serum AFP(Alpha fetoprotein in each group was determined by electrochemiluminescence method. The expression of RBM8A and its diagnostic value in HCC were analyzed. Results: 1. The peripheral blood samples were collected from 340 patients, including 110 patients with primary liver cancer and 55 patients with liver cirrhosis. The expression of RBM8A in liver cancer group was significantly higher than that in cirrhosis group. Other malignant tumor groups and healthy persons (2.271 1.730 + 0.381 鹵0.121 鹵1.307 鹵1.003 鹵0.255 鹵0.067 P0.05) showed significant difference in the expression of AFP. There were significant differences in the expression of AFP between different tumor groups (鈮，

本文編號(hào)：1537492