Elkammah Maha, Gowily Ahmed, Okda Tarek, Houssen Maha
Department of Biochemistry, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt.
Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Contemp Oncol (Pozn). 2020;24(4):216-220. doi: 10.5114/wo.2020.102818. Epub 2021 Jan 4.
Soluble Toll-like receptor 4 (sTLR4) is a negative regulator of TLR4 signalling that has been reported in different diseases. In this study, we aimed to assess the serum levels of sTLR4 in hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) and to investigate the correlation of sTLR4 with clinicopathological and biochemical parameters among HCV-related HCC patients and hepatitis C without HCC patients.
Fifty patients with HCV-related HCC, 50 patients with hepatitis C without HCC and 50 healthy control volunteers were enrolled. Clinicopathological and biochemical parameters were examined in all patients. Serum levels of sTLR4 were measured using enzyme-linked immunosorbent assay.
A significant increase in serum sTLR4 was detected in patients with HCV-related HCC (4436.1 ±7089.8) (pg/ml) ± compared to the level in patients with hepatitis C without HCC (1561.4 ±532.0) (pg/ml) ( = 0.002) and the level in the control group (1170.38 ±159.42) (pg/ml) ( < 0.001). Serum sTLR4 was positively correlated with serum AST activity, serum direct bilirubin levels, serum alpha fetoprotein levels, tumour stages of HCC according to the Barcelona Clinic Liver Cancer staging system (BCLC), and the severity of liver cirrhosis according to the Child-Pugh classification among the patients with HCV-related HCC. The combination of serum alpha fetoprotein and serum sTLR4 increased the sensitivity of HCC detection to 76% and the specificity to 94%.
Serum sTLR4 may be a marker for HCC susceptibility among HCV-infected patients.
可溶性Toll样受体4（sTLR4）是TLR4信号传导的负调节因子，已在不同疾病中被报道。在本研究中，我们旨在评估丙型肝炎病毒（HCV）相关肝细胞癌（HCC）患者血清中sTLR4水平，并研究sTLR4与HCV相关HCC患者及非HCC丙型肝炎患者临床病理和生化参数之间的相关性。
纳入50例HCV相关HCC患者、50例非HCC丙型肝炎患者和50名健康对照志愿者。检测所有患者的临床病理和生化参数。采用酶联免疫吸附测定法检测血清sTLR4水平。
与非HCC丙型肝炎患者（1561.4±532.0）（pg/ml）的水平相比，HCV相关HCC患者血清sTLR4显著升高（4436.1±7089.8）（pg/ml）（P = 0.002），与对照组（1170.38±159.42）（pg/ml）相比差异也有统计学意义（P < 0.001）。在HCV相关HCC患者中，血清sTLR4与血清谷草转氨酶活性、血清直接胆红素水平、血清甲胎蛋白水平、根据巴塞罗那临床肝癌分期系统（BCLC）的HCC肿瘤分期以及根据Child-Pugh分类的肝硬化严重程度呈正相关。血清甲胎蛋白和血清sTLR4联合检测可将HCC检测的敏感性提高到76%，特异性提高到94%。
血清sTLR4可能是HCV感染患者HCC易感性的一个标志物。
