Plasma Levels Of HB-EGF And AR And Clinical Significance In Patients With Chronic Hepatitis,cirrhosis And Primary Hepatocellular Carcinoma

Objective:To analyze the action of HB-EGF and AR in the occurrence and development of chronic liver disease.We evaluated the expressions of HB-EGF and AR in plasma of chronic hepatitis,cirrhosis,primary hepatocellular carcinoma and healthy subjects,and study the relationship among the HB-EGF,AR and some of the clinical biochemical indicators reflecting the severity of hepatic function.To explore the change characteristics of these indicators in the evolution of hepatitis,cirrhosis and liver cancer patients,may provide a certain direction for disease evaluation and prognosis.Methods:From March 2018 to Six 2018,we collected 76 hospitalized patients in the department of gastroenterology and oncology,affiliated hospital of Hebei University of technongy,who met the diagnostic criteria.23 patients with chronic hepatitis(13 men and 10 women,averageage 51.67±14.59 years),35 patients with cirrhosis(19 men and16 women,averageage 57.90 ± 13.04 years),18 patients with primary liver cancer(14men and 4 women,averageage 59.94 ± 9.48 years)and 12 sex,age-matched healthy subjects(7 men and 5 women,averageage 58.00 ± 9.95 years)were included in the present study.All subjects had no other diseases,without pregnancy,without hyperlipidemia,didn't apply human blood albumin,hormone,interferon,and did not take the medicine which could produce liver damage.There was no significant difference in age and gender among the four groups.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression of some members of the epidermal growth factor family in the plasma of patients in each group,including Amphiregulin and heparin-binding epidermal growth factor.We can combined the clinical data do statistical analysis to make evaluation.Results:1.The plasma concentrations of AR level in hepatitis,liver cirrhosis and hepatocellular carcinoma patients was higher than that of the control group(P<0.001),The concentrations of AR level in plasma of patients with liver cancer was significantly higher than that of patients with liver cirrhosis and chronic hepatitis(P<0.001),and AR level in plasma of patients with liver cirrhosis was higher than that of patients with chronic hepatitis(P<0.05).2.The plasma concentrations of HB-EGF level in hepatitis,liver cirrhosis and hepatocellular cinoma patients was higher than that of the control group(P<0.001),The concentrations of HB-EGF level in plasma of patients with liver cancer was higher than that of patients with chronic hepatitis(P<0.05),and HB-EGF level in plasma of patients with liver cirrhosis was higher than that of patients with chronic hepatitis,and lower than the group of liver cancer,but no significant difference was detected(P>0.05).3.The plasma concentrations of HB-EGF level and amphiregulin level increased with liver function grading,that is,Child A<Child B<Child C,the plasma levels of HB-EGF and amphiregulin in Child C group were higher than those in Child B group and Child A group(P<0.05),but there was no significant difference between Child A group and Child B group(P>0.05).4.For patients with liver function examination of alanine aminotransferase(ALT)and aspartate aminotransferase(AST),compared with normal control group,liver cirrhosis and liver cancer group hepatitis group increased significantly(P<0.05),while liver cirrhosis and liver cancer group higher than normal control group compared with the two indicators,but there was no statistically significant difference(P>0.05).5.In hepatocellular carcinoma patients,we found that it was no obvious correction between HB-EGF and AFP(r=0.301,P>0.05),and no significant relationship was found between AR and AFP(r=0.211,P>0.05).In 16 PHC,the positive rate of AFP,HB-EGF and AR were 37.5%,68.75%,37.5% respectively.Fisher's exact probability test showed no significant difference in the positive rates of the three groups(P>0.05).Among the 6AFP positive liver cancer patients,1 was AR negative(16.67%)and 3 was HB-EGF negative(50%).Among the 10 AFP negative liver cancer patients,6(60%)were AR positive,and 3(30%)were HB-EGF positive.Therefore,the results of this study suggest that AR and HB-EGF cannot replace AFP,because AR and HB-EGF have no obvious changes in some liver cancer patients.Maybe AR,HB-EGF and AFP have complementary effects on the detection of hepatocellular carcinoma,and combined detection can improve the positive detection rate of liver cancer.Conclusions:1.The expression of HB-EGF and AR in the plasma of the experimental group was significantly higher than the normal level,and with the disease condition from chronic hepatitis,cirrhosis to liver cancer gradually increased,suggesting that it might be possible to assist in assessing the development stage of chronic liver disease,monitoring dynamic changes,and providing assistance for the evaluation of clinical conditions.2.Changes in plasma HB-EGF,AR and AFP are not necessarily synchronized.It is reminded that when monitoring patients with chronic liver disease,simultaneous monitoring can complement each other in order to reduce the number of cases of liver cancer missed diagnosis.