Clinical Significance And Expression Of IGFs In Serum Of Normal People, HBsAg-positive People And Patients With Primary Hepatic Carcinoma

Primary hepatic carcinoma (PHC) is the most common malignant tumor in China, and its mortality is increasing in recent years.The mortality of paients with PHCwas 20.37 per one million, and the mortality of male was 29.01 per million which was just less than gastric carcinoma in the countryside and lung cancer in the cities , and the mortality of female was 11.21 per million which was less than gastric carcinoma and esophageal carcinoma. It was indicated that a major cause factor of liver cancer is the viral infection (mainly type B and type C) in China, and HBV is the most common cause factor of all the factors, China's population HBsAg prevalence is as high as 10%,according to the surveys. It was founded that PHC and HBV infection were closely related, it is 98-times for HBsAg positive higher than normal people in the relative risk of PHC. According to epidemiological surveys,it is 90% in HBV-positive.marker in patients with PHC in China.The main symptoms of PHC come from liver disease itself and its background of HBV infection. on the liver ,it may be asymptomatic in the early stage, .but they will be more difficult to treat once the onset of symptoms and larger tumors. At present,AFP is the most commonly used tumor markers in clinical diagnosis of the PHC.The sensitivity of diagnosis of liver cancer is 32% to 93% and specificity is 61% ~ 100%,and it can make the diagnosis earlier before the symptoms coming out for 6~12 months ,and it is one of the most useful method of early diagnosis of primary hepatic carcinoma (PHC) in clinical application,and plays an important role in diagnosis,differential diagnosis,prognosi judgement and screening of PHC. However, the detection of AFP is influenced by some factors, about 30% of patients are missed. it will play an very important role in liver cancer dignosis, to the search for other effective tumor markers,the application of a variety of tumor markers and the diagnosis association with AFP ,to reach the early detection, early diagnosis, early treatment of the "three early" target. It was found that insulin-like growth factor family (IGFs) expressed anormaly in the PHC diseases.This study is to detect the IGFs levels in serum of the normal people, HBsAg positive patients and primary liver cancer patients, and to discuss the function of occurrence and development of normal people, HBsAg positive patients and primary liver cancer patients, and to discuss the value of PHC diagnosis by detection serum IGFs levels association with AFP.Objectives1. To observe the expression of IGFs in serum of patients with PHC, HBsAg-positive people and normal people;2. To dynamic observe the expression of IGFs in serum of patients with hepatoma both before and after operation and transcatheter hepatic arterial chemoembolization (TACE);3. To observe the sensitivity and specificity of IGFs in diagnosis of hepatoma;4. To observe the different positive rate of patients in PHC of IGFs group with positve and negtive HBV-DM;5. To observe the diagnostic value of associated detection of IGF and AFP in serum;6. Observe expression of IGFs in serum of patients with primary liver cancer。Material and Method1. A part of all the individuals selected come from the investigations of liver cancer epidemiological during September 2007~September 2008. Selected 20 cases randomly as normal group, selected 20 cases randomly as HBsAg positive group. Primary liver cancer group are 37 cases, in which one part is 12 cases of surgical treatment, the other part is 15 cases for the treatment of TACE. Get fasting venous blood samples of patients of the four group. liver surgery group and after TACE in patients treated get fasting venous blood samples after 1-2 weeks and 3 ~ 4 weeks respectively efference ,get supernatant liquid put the serum in-80℃refrigerator ,so as to detect;2. To sing ELISA (enzyme linked immunosorbent assay, ELISA) methed to detect the IGF-1, IGF-2, IGF-3 and IGFBP-3 levels in serum of the patient of the four groups;3. To use the method of Electrochemiluminescence to measure the the level of AFP in serum of the people in four groups In this study data were expressed with mean±standard deviation ( X±S),analyzed through SPSS 13.0 for windows statistical software. Applied statistical methods included: Completely randomized design data. Use the One-way ANOVA statistical method, The data of many levels and two factors repeated measure analysis of variance statistical method, applied multiple comparison of the mean analysis of variance; Compared the rate with the chi-square test; Analyzed the relevance between。different indexs with linear correlation mothed. significant level ofα= 0.05.Results1. The serum IGF-1, IGF-2, IGFBP-2, IGFBP-3 and AFP both in the expression of each group. there was no significant difference of expression betweet HBsAg (+) group and normal group of IGF-1and IGF-2,(p=0.095,p=0.327,p=1.000),but there was significant difference of expression betweet HBsAg (+) group and normal group of IGFBP-2,IGFBP-3 and the serum AFP concentration; there was significant difference of expression both HBsAg (+) group both HBsAg (+) group and PHC group of IGF-1, IGF-2, IGFBP-2, IGFBP-3, (every group is p=0.000),and as the same as betweet normal group and PHC group. (every group is p=0.000).2. In the PHC group, AFP, IGF-1, IGF-2, IGFBP-2 and IGFBP-3-positive rates were 81.08%, 59.46%, 64.86%, 54.05% and 48.65%. By the chi-square test showed no positive rate of statistical significance. (p <0.05).3. The PHC group in 30 cases of AFP-positive patients with IGF-1, IGF-2, IGFBP-2 and IGFBP-3 the number of positive cases were detected in 22 cases, 24 cases, 20 cases and 18 cases, and seven cases of AFP in the negative PHC patients with IGF-1, IGF-2, IGFBP-2 and IGFBP-3 the number of positive cases were detected in 3 cases, 5 cases, 5 cases and 6 cases, IGF-1, IGF-2, IGFBP-2 , and IGFBP-3 were negative there are 0 cases.4. The IGF-1, IGF-2, IGFBP-2 and IGFBP-3 were positive for 1 case, the difference was not statistically significant. (p = 0.327, p = 0.690, p=0.317, p=0.737).IGF-1, IGF-2,IGFBP-2 and IGFBP-3 alone detection sensitivity of 63.33%, respectively, 63.33%, 50.00 % and 50.00%.; specificity 42.86%, 71.43%, 71.43% and 42.86%5. The IGF-1, IGF-2, IGFBP-2 and IGFBP-3 in the positive rate of PHC group of patients with HBV-DM-positive and-negative patients were 62.07%, 71.43%, 50.00%, 39.29% and44.44%,44.44%,66.67%77.78%. IGF-1, IGF-2 and IGFBP-2 by the positive rate between the two chi-square test positive rate was no significant difference (p > 0.05); The positive rate of IGFBP-3 by the chi-square test positive rates of the two significant differences (p <0.050)6. PHC group and the surgical TACE preoperative and postoperative 1 week and after 2 weeks of serum IGF-2, IGFBP-2 levels were significantly higher than that after surgery and TACE treatment, with significant differences (p <0.05 ); IGF-1 and IGFBP-3 were significantly lower than after surgery and TACE treatment, with significant differences (p <0.05).Conclusions1. IGF-1 and IGFBP-3 concentrations in the normal group, HBsAg(+) group and in patients with PHC in order to reduce the positive rate of detection, and serum IGF-2, IGFBP-3 levels in the normal group, HBsAg(+) group and the PHC patients followed by higher positive rate of detection, suggesting that serum IGF-1, IGF-2, IGFBP-2, IGFBP-3 levels and the occurrence and development of PHC is closely related.2. The serum of IGF-2, IGFBP-2 levels and AFP of PHC was positively correlated, suggesting that serum IGF-2, IGFBP-2 levels higher, AFP levels are higher; and IGF-1 and IGFBP-3 and AFP levels were significantly negative correlation, suggesting that serum IGF-1 and IGFBP-3 levels higher and lower levels of AFP;3. The serum of IGF-1, IGF-2, IGFBP-2, IGFBP-3 concentration of PHC can be detected not only as a diagnostic screening PHC indicators, AFP can be used as diagnostic indicators of negative PHC;4. The serum of IGF-1, IGF-2, IGFBP-2, IGFBP-3 and AFP of PHC joint detection can improve the positive rate in patients with PHC, the PHC patients have a certain diagnostic value of5. The serum of IGFBP-3 levels of PHC are closely related with HBV infection, HBV-infected persons than IGFBP-3 levels were not significantly higher infection; serum IGF-1, IGF-2 and IGFBP-2 levels is not associated with HBV infection6. The serum of IGF-1, IGFBP-3 levels of PHC after treatment than before treatment was significantly increased, and IGF-2 and IGFBP-2 levels after treatment than before treatment significantly decreased, suggesting that serum IGF-1, IGF-2, IGFBP -2 , IGFBP-3 levels can be used to determine the concentration of the treatment of patients with PHC evaluation.