CAJ | 학술논문

目的：通过动态检测大鼠肝癌模型造模各阶段血清中TGF-β1和HSP70水平并与传统指标AFP比较，对其在肝癌早期诊断中的价值做综合的评价。方法：用CCL4诱导大鼠肝硬化基础上的肝癌模型。从造模第6周起，每两周心脏采血一次，ELISA法检测大鼠血清中TGF-β1、HSP70和AFP水平，并取部分肝组织行病理学检查。结果：造模第8周发生肝硬化，第10周发生不典型增生及早期肝癌结节。造模第10周TGF-β1和HSP70水平即显著升高， TGF-β1在肝硬化阶段无显著升高，而HSP70则略微有升高，二者特异性分别为90%和60%，阳性率分别为55%和70%，联合检测的阳性率为80%，造模第12周的阳性率分别达85%和90%，联合检测阳性率达100%；AFP水平在造模第12周才有显著升高，肝硬化阶段也有升高并与早期肝癌无显著性差异。其阳性率和特异性分别为60%和30%。结论：传统指标AFP对极早期的肝癌不敏感，特异性不高，而TGF-β1和HSP70均较AFP敏感、特异，二者联合可提高检测敏感性。
목적：통과동태검측대서간암모형조모각계단혈청중TGF-β1화HSP70수평병여전통지표AFP비교，대기재간암조기진단중적개치주종합적평개。방법：용CCL4유도대서간경화기출상적간암모형。종조모제6주기，매량주심장채혈일차，ELISA법검측대서혈청중TGF-β1、HSP70화AFP수평，병취부분간조직행병이학검사。결과：조모제8주발생간경화，제10주발생불전형증생급조기간암결절。조모제10주TGF-β1화HSP70수평즉현저승고， TGF-β1재간경화계단무현저승고，이HSP70칙략미유승고，이자특이성분별위90%화60%，양성솔분별위55%화70%，연합검측적양성솔위80%，조모제12주적양성솔분별체85%화90%，연합검측양성솔체100%；AFP수평재조모제12주재유현저승고，간경화계단야유승고병여조기간암무현저성차이。기양성솔화특이성분별위60%화30%。결론：전통지표AFP대겁조기적간암불민감，특이성불고，이TGF-β1화HSP70균교AFP민감、특이，이자연합가제고검측민감성。
Objective:To investigate the value of TGF-β1 and HSP70 in hepatoma early diagnoses by detecting their levels in different stage of the rat hepatoma model and comparing them with AFP. Methods:Using CCL4 to establish rat hepatoma model based on liver cirrhosis. Drawing blood from the heart every two weeks from the sixth week following the beginning of the model establishing, using ELISA to detect the TGF-β1、HSP70 and AFP level in the rat serum, and taking part of the liver tissue to do pathology inspection to see the progression of the model establishing. Results:The cirrhosis appeared by the eighth week, and hepatoma appeared by the tenth week. TGF-β1 and HSP70 levels stepped-up significantly in the tenth week. TGF-β1 did not rise in the stage of cirrhosis, while HSP70 rose slightly in the stage of cirrhosis. The specificity of TGF-β1 and HSP70 were 90% and 60%respectively, and the sensitivity in the tenth week were 55%and 70%, respectively. The sensitivity of combined detection was 80%. The sensitivity in the twelfth week raised to 85%and 90%, respectively, and the sensitivity of combined detection raised to 100%. AFP rose later on the twelfth week significantly. It also rose in the stage of cirrhosis and had no significant difference between the very early hepatoma(the tenth week). The sensitivity and specificity of AFP were 60%and 30%respectively. Conclusion:we have established the hepatoma model based on cirrhosis successfully. The traditional index AFP is not very sensitive in the very early stage of hepatoma and also not very specific. TGF-β1 and HSP70 is more sensitive and specific than AFP in the early diagnosis of hepatoma, and the combined detection of TGF-β1 and HSP70 can raise the sensitivity.