Abstract
AIM: To explore the expression of serum leptin (Lep), vascular endothelial growth factor (VEGF) and alpha-fetoprotein (AFP) and their clinical significances in hepatocelluar carcinoma (HCC).
METHODS: Enzyme-linked immunosorbent assay (ELISA) was used to detect serum Lep, VEGF and AFP levels in 146 patients with HCC, 31 patients with liver cirrhosis and 30 healthy controls. The correlations Lep, VEGF, and AFP expression with clinical indexes were analyzed.
RESULTS: The serum Lep level was correlated with body mass index (BMI) in HCC patients (r = 0.64, P < 0.01), and significantly lower than that in cirrhotic patients and healthy controls (19 μg/L vs 35, 27 μg/L, P < 0.05). The serum Lep level in HCC patients was significantly decreased with upgrade of TNM stages, metastasis and recurrence (P < 0.05). In comparison with that in cirrhotic patients and healthy controls, the serum VEGF level in HCC patients was significantly increased (398 ng/Lvs 179, 167 ng/L, P < 0.01). There was no correlation between VEGF and AFP expression. The sensitivity and specificity of VEGF were 71.2% and 80.6%, and those of AFP were 73.3% and 83.9%, respectively, in the diagnosis of HCC. However, the sensitivity was increased to 91.8%, while the accuracy reached 90.4% after the combined detection of VEGF and AFP was used. There was a relationship beween the level of serum VEGF and tumor size (<3 cm: 237 ± 96 ng/L, >3 cm: 398 ± 124 ng/L, P < 0.01). As compared with that of TNMⅠ, Ⅱ stage, the serum VEGF of TNM Ⅲ, Ⅳstage was obviously higher (346 ± 131, 401 ± 152 ng/L vs 228 ± 89, 259 ± 102 ng/L, P < 0.01), and it also showed a significant elevation in the patients with metastasis and recurrent HCC (P < 0.01).
CONCLUSION: Nutrition status and prognosis of patients with HCC can be judged by serum Lep level, and the combined detection of serum VEGF and AFP may provide a significant marker for HCC diagnosis and prognosis.
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