Department of Nursing, Binzhou Vocational College, Binzhou, People's Republic of China.
World J Surg. 2013 Oct;37(10):2419-27. doi: 10.1007/s00268-013-2132-4.
Hepatoma-derived growth factor (HDGF) has been reported to play a pivotal role in the development and progression of several tumors. The aim of the present study was to analyze whether HDGF is a potential prognostic and diagnostic marker for extrahepatic cholangiocarcinoma (EHCC).
The immunostaining of HDGF was analyzed by immunohistochemistry for 65 pathologically confirmed EHCC, and its correlation with clinicopathologic factors and prognosis was investigated. Meanwhile, to evaluate the diagnostic value of HDGF, an enzyme-linked immunosorbent assay (ELISA) was performed to measure HDGF levels in the serum samples of 83 EHCC patients and 51 healthy controls.
Positive expression of HDGF was detected in 30 (46.2 %) patients with EHCC and correlated with poor tumor differentiation (P = 0.024). Univariate analysis showed that the positive HDGF expression group had a significantly poorer survival rate than the negative HDGF expression group did (P < 0.001). Multivariate analysis demonstrated that HDGF expression and N stage were independent prognostic factors. The mean serum HDGF level in EHCC patients was 2.39-fold higher than that in healthy controls (P = 0.002). The optimal cut-off value for HDGF was 122.15 pg/mL, providing a sensitivity of 66.27 % and a specificity of 88.24 %. The area under the curve (AUC) of HDGF was 0.807 (95 % confidence interval 0.730-0.870), demonstrating that HDGF was a potential biomarker for EHCC.
HDGF was a valuable independent prognostic factor after curative resection in EHCC, and it provided an important basis for screening/treating high-risk patients. Meanwhile, our study indicated that serum HDGF levels can be used as a noninvasive and potential diagnostic marker for EHCC.
已有研究报道肝癌衍生生长因子（HDGF）在多种肿瘤的发生和发展中发挥着关键作用。本研究旨在分析 HDGF 是否是一种潜在的与预后相关的外胆管癌（EHCC）诊断标志物。
采用免疫组化法检测 65 例经病理证实的 EHCC 组织中 HDGF 的表达，并分析其与临床病理因素及预后的相关性。同时，采用酶联免疫吸附试验（ELISA）检测 83 例 EHCC 患者和 51 例健康对照者血清中 HDGF 的水平，评估 HDGF 的诊断价值。
在 30 例（46.2%）EHCC 患者中检测到 HDGF 阳性表达，且与肿瘤分化程度差相关（P=0.024）。单因素分析显示，HDGF 阳性表达组患者的生存率明显低于 HDGF 阴性表达组（P<0.001）。多因素分析表明，HDGF 表达和 N 分期是独立的预后因素。EHCC 患者血清 HDGF 水平平均比健康对照组高 2.39 倍（P=0.002）。以 122.15 pg/mL 为 HDGF 的最佳截断值，其诊断 EHCC 的灵敏度为 66.27%，特异度为 88.24%。HDGF 的曲线下面积（AUC）为 0.807（95%置信区间为 0.730-0.870），表明 HDGF 是 EHCC 的一种潜在生物标志物。
HDGF 是 EHCC 根治性切除术后有价值的独立预后因素，为筛选/治疗高危患者提供了重要依据。同时，本研究表明血清 HDGF 水平可作为 EHCC 的一种非侵入性、潜在的诊断标志物。
