目的 探讨α胰蛋白酶H4重链(inter-alpha-trypsin inhibitor heavy chain 4,?ITIH4)在原发性肝细胞癌(hepatocellular carcinoma,?HCC)早期预警中的价值.方法 对肝硬化患者进行随访观察,检测发展为HCC的患者在随访前和确诊为HCC后血清中ITIH4浓度的动态变化.结果 109例肝硬化患者经过2年随访,共有29例发展为HCC(26.6%), ITIH4浓度在HCC组显著低于非HCC组(P=0.000),ROC曲线分析显示其对HCC进展预测的AUC为0.667,预测价值优于AFP.对发展为HCC患者血清动态样本进行检测,发现ITIH4在HCC进展过程中呈下降趋势(P=0.006).结论 ITIH4具有HCC进展预警价值和动态监测作用,具有很好的应用前景.%Objective To investigate the significance of inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) for the early warning of hepatocellular carcinoma (HCC). Methods A total of 109 liver cirrhosis patients were followed up, the concentrations of ITIH4 in patients' serum were determined and compared before follow-up and upon the diagnosis. Results After two years of follow-up, 26.6% (29/109) of liver cirrhosis patients developed HCC, serum levels of ITIH4 in HCC patients were significantly lower than those in non-HCC patients (P=0.000). The area under the ROC Curve was 0.667 and the predictive value of ITIH4 was better than AFP. Serum dynamic samples in HCC patients were further detected, and results showed that ITIH4 level of liver cirrhosis patients decreased significantly after developed HCC (P=0.006). Conclusions ITIH4 has early predicting value for HCC progression and can serve as a dynamic monitor. Therefore, this serum marker is better than AFP and has the good application prospect.
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