The Study On The Detection Of Serum VEGF And TSGF In The Diagnosis Of Primary Liver Cancer And The Eurative Effect And Evaluation After TACE

Background: A fetoprotein(AFP), as a kind of specific serological protein markers has played an important role in the diagnosis of primary hepatocellular carcinoma(PHC)and the eurative effect and evaluation after surgery, Interventional therapy. The specific degree AFP in the diagnosis of PHC is high, however, its sensitivity is lower, and AFP can’t be used to judge therapeutic effect objectively in preoperative patients with AFP negative.So find other sensitive and specific serological markers for the diagnosis of PHC and evaluation of its curative effect has important clinical practical value.Objectives:1. Through the determination of serum VEGF and TSGF expression level in benign and malignant liver disease, its diagnostic value in different benign and malignant liver disease, further explore joint detection of VEGF and TSGF feasibility and important significance in the diagnosis of PHC. 2. Through the determination of PHC patients serum VEGF and TSGF expression levels before and after the hepatic artery embolism chemotherapy(TACE), to analyze its relationship with interventional treatment and its value for therapeutic intervention and prognosis judgement.Methods:Selection 171 PHC patients cases, 65 cases of patients with liver cirrhosis, 51 cases of patients with hepatitis and healthy physical examination of 56 cases, a total of 343 cases of patients hospitalized in our hospital between January 1, 2014 to December 31,2014. All entrants are through symptoms, signs and routine blood, and clotting function, liver function, AFP and other laboratory examination and epigastric enhancement CT and/or enhanced magnetic resonance imaging(MRI) or B chao deng imaging examination comprehensive evaluation index.Detect the serum VEGF and TSGF expression levels, and the conventional patient has been treated with follow-up.Results: 1, PHC patients serum VEGF and TSGF expression levels significantly higher than other group(P < 0.05). Serum VEGF and TSGF expression levels of AFP negative PHC group was also significantly higher than other groups(P < 0.05). 2, Correlation coefficient of VEGF and AFP, TSGF and AFP, VEGF and TSGF is 0.364, 0.243, 0.276, respectively. 3,The sensitivity of three separate tests of AFP, VEGF, TSGF were 63. 7%, 88.3%, 59.65% respectively, specific degree were 76.74%, 75.58% and 83.14% respectively. The sensitivity of VEGF and TSGF combined AFP, VEGF combined AFP, TSGF combined AFP and VEGF in combination of the TSGF test in the diagnosis of PHC were 98.25%, 89.47%, 92.98%, 89.47%, specific degree were 41.86%, 51.74%, 63.37% and 51.74% respectively. 4, Single detection of serum VEGF and TSGF, AFP in the diagnosis of PHC under the ROC curve of AUC were 0.861, 0.795, 0.715, with significant difference(P < 0.05);The detection of VEGF combined AFP, TSGF combined AFP, VEGF combined TSGF, VEGF and TSGF combined AFP in the diagnosis of PHC under the ROC curve of AUC were 0.881, 0.868, 0.892, 0.881,with no significant difference(P > 0.05). 5, The sensitivity of serum VEGF, TSGF alone detection and the combined detection of VEGF with TSGF in AFP negative PHC were 70.49%, 57.38%, 88.52%, specificity 75.58%, 83.14% and 75.58% respectively;Serum VEGF, TSGF alone and VEGF with TSGF test in the diagnosis of PHC under the ROC curve of AFP negative AUC were 0.753, 0.755, 0.832, 3 person was no significant difference(P > 0.05). 6, in the different level of AFP in PHC group, compared with preoperative, postoperative 1 month with conventional VEGF, TSGF, serum concentrations were significantly decreased(P < 0.05), and in the PHC group of AFP negative, conventional TACE postoperative 1 month compared with preoperative, VEGF, TSGF, serum concentration has also dropped significantly(P < 0.05). 7, the log- rank analysis shows: preoperative AFP and VEGF on all affect the survival rate after treatment with conventional(P < 0.05);Preoperative TSGF forconventional had no effect on survival after treatment(P > 0.05).Conclusions: 1, Serum VEGF and TSGF levels of PHC patients were significantly higher than the patients with cirrhosis of the liver, hepatitis group and healthy controls,they might be promoting factors of PHC occurrence, development and have important value for diagnosis of PHC. 2,AFP, VEGF, TSGF separate detection in the diagnosis of PHC, its value were VEGF > TSGF > AFP.Two joint inspection or three joint of AFP, VEGF, TSGF has no advantage in the diagnosis of PHC. 3, Separate detection of VEGF, TSGF in AFP negative PHC patients has good diagnostic value, but the joint detection have no advantage. 4, serum AFP, VEGF may be independent risk factors of influencing curative effect and prognosis with conventional,And TSGF was of no value in deciding with conventional curative effect and prognosis.For PHC patients with AFP negative, VEGF may with good evaluation value on curative effect with conventional PHC patients.