目的：探讨白介素6（interleukin－6， IL－6）、IL－1β、IL－10、IL－17、肿瘤坏死因子α（tumor necrosis factorα， TNF－α）及IL－27在原发性肝癌患者血清中的水平及其与肝癌发生和转移的关系。方法收集我院2012年1月－2014年12月确诊的原发性肝癌患者100例，分为无转移组48例和肝转移组52例，采用Luminex xMAP技术检测血清细胞因子IL－6、IL－1β、IL－10、IL－17、TNF－α及IL－27，并对数据进行统计分析。结果肝转移组患者IL－17和IL－27水平均显著高于无转移组，差异均有统计学意义（P均＜0.05）。肝转移组患者中，仅IL－17与IL－1β呈正相关（r＝0.275，P＝0.048）。受试者工作特征曲线分析结果显示，IL－17和IL－27诊断肝癌转移的曲线下面积分别为0.664和0.818，最佳诊断cutoff值分别为2.005 pg／mL和238.95 pg／mL，敏感性分别为83.3％和98.5％，特异性分别为35.7％和64.3％，阳性预测值分别为58.1％和62.1％，阴性预测值分别为43.4％和44.4％，约登指数分别为35.7和62.8。结论 IL－17和IL－27均为促进肝癌细胞生长的细胞因子，可作为预测肝癌转移及预后的有效指标。 IL－27对诊断肝癌转移的临床诊断性能指标水平均高于IL－17，对肝癌早期转移的诊断价值更好。%Objective To investigate the levels of IL-6, IL-1β, IL-10, IL-17, TNF-αand IL-27 in the serum of patients with primary hepatocellular carcinoma , and to explore their relationship with hepato-cellular carcinoma. Methods 100 hepatocellular carcinoma patients were collected from January 2012 to De-cember 2014 in our hospital, which were divided into non-metastasis group (48 cases) and hepatic metastasis group(52 cases). All cytokines were detected by Luminex xMAP technology, and all data were analyzed statis-tically. Results Levels of IL-17 and IL-27 in hepatic metastasis group were all higher than that of non-metastasis group, and the differences all had statistical significance (Pall<0.05). In hepatic metastasis group, only IL-17 and IL-1βhad positive correlation (r=0.275,P=0.048). Receiver operating characteristic curve showed that the area under the curve of IL-17 and IL-27 detection of hepatocellular carcinoma metastasis was 0.664 and 0.818, respectively. And the cutoff value were 2.005 pg/mL and 238.95 pg/mL. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index of IL-17 de-tection of hepatic metastasis were 83.3%, 35.7%, 58.1%, 43.4% and 35.7, respectively. The sensitivity, specificity, PPV, NPV and Youden index of IL-27 detection of hepatic metastasis were 98.5%, 64.3%, 62.1%, 44.4%and 62.8, respectively. Conclusion IL-17 and IL-27 are cytokines which promote occur-rence, development and metastasis of hepatocellular carcinoma. IL-17 and IL-27 can be used as effective pre-dictors of liver cancer metastasis and prognosis. The clinical diagnosis of performance indicators levels of IL-27 in hepatocellular carcinoma are all higher than that of IL-17 , which has better diagnosis value to the early metastasis of hepatocellular carcinoma.
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