在丙型肝炎病毒高危患者中，细胞角蛋白对准确诊断肝细胞癌的临床实用性。

Clinical Utility of Cytokeratins for Accurate Diagnosis of Hepatocellular Carcinoma Among Hepatitis C Virus High-Risk Patients.

机构信息

Department of Chemistry, Helwan University, Cairo, Egypt.

Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt.

出版信息

Asian Pac J Cancer Prev. 2024 Apr 1;25(4):1325-1332. doi: 10.31557/APJCP.2024.25.4.1325.

DOI:10.31557/APJCP.2024.25.4.1325

PMID:38679993

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11162728/

Abstract

OBJECTIVES

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and a global health problem. It is often diagnosed at advanced stage where hopeless for effective therapies. Identification of more reliable biomarkers for early detection of HCC is urgently needed. Cytokeratins are a marker of hepatic progenitor cells and act as a key player in tumor invasion. Herein, we sought to develop a novel score based on the combination of cytokeratin 18 (CK18) and cytokeratin 19 (CK19) with routine laboratory tests for accurate detection of HCC.

MATERIAL & METHODS: Serum CK18, CK 19, α-fetoprotein, albumin and platelets count were assayed in HCC patients (75), liver cirrhosis patients (55) and healthy control (20). Areas under receiving operating curve (AUCs) were calculated and used for construction on novel score. A novel score named CK-HCC = CK 19 (ng/ml)×0.001+ CK18 (ng/ml)×0.004 + AFP (U/L)×5.4 - Platelets count (×109)/L×0.003 - Albumin (g/L)×0.27-36 was developed. CK-HCC score produces AUC of 0.919 for differentiating patients with HCC from those with liver cirrhosis with sensitivity and specificity of a cut-off 1.3 (i.e., less than 1.3 the case is considered cirrhotic, whereas above 1.3 it is considered HCC.

CONCLUSION

CK-HCC score could replace AFP during screening of HCV patients and early detection of HCC.

摘要

目的

肝细胞癌（HCC）是肝脏的原发性恶性肿瘤，也是一个全球性的健康问题。由于缺乏有效的治疗方法，HCC 通常在晚期被诊断出来。因此，迫切需要寻找更可靠的生物标志物来早期检测 HCC。细胞角蛋白是肝祖细胞的标志物，是肿瘤侵袭的关键因素。在此，我们试图开发一种基于细胞角蛋白 18（CK18）和细胞角蛋白 19（CK19）与常规实验室检测相结合的新型评分系统，以准确检测 HCC。

材料与方法

检测 HCC 患者（75 例）、肝硬化患者（55 例）和健康对照者（20 例）的血清 CK18、CK19、甲胎蛋白（AFP）、白蛋白和血小板计数。计算受试者工作特征曲线（ROC）下的面积，并用于构建新型评分。一种名为 CK-HCC 的新型评分命名为 CK19（ng/ml）×0.001+ CK18（ng/ml）×0.004+AFP（U/L）×5.4-血小板计数（×109）/L×0.003-白蛋白（g/L）×0.27-36。CK-HCC 评分用于区分 HCC 患者和肝硬化患者的 AUC 为 0.919，截断值为 1.3（即低于 1.3 为肝硬化，高于 1.3 为 HCC），具有较高的敏感性和特异性。