外周血趋化因子RANTES对肝细胞癌的诊断价值

目的探讨外周血调节活化正常T细胞分泌与表达因子（regulateduponactivationnormalTcellex．pressedandsecreted，RANTES）对乙肝病毒相关的肝细胞癌（HCC）的诊断价值。方法选择北京佑安医院2010年2月至2011年11月收治的慢性乙型肝炎患者35例、乙型肝炎肝硬化患者34例及乙肝病毒相关HCC患者47例。Luminex技术检测外周血清中趋化性细胞因子RANTES水平。结果HCC患者外周血RANTES水平[（23．27±21．16）ng/m1]明显高于慢性乙型肝炎[（7．81±4．06）ng／m1]及乙肝肝硬化患者[（5．36±6．13）ng／m1]，3组比较差异有统计学意义（P〈0．001）。HCCⅡ期患者外周血RANTES水平明显高于I期患者，差异有统计学意义（31．94±25．94）ng／mlVS．（14．24±8．10）ng／ml，P=0．004]。RANTES预测慢性乙型肝炎、乙肝肝硬化进展为HCC的阈值为7．85ng／ml，敏感性为93．5％，特异性为72．5％。结论HCC患者外周血中趋化因子RANTES水平明显增高，且HCCⅡ期患者RANTES水平明显高于I期患者．可作为乙肝病毒相关HCC诊断及病情评估的参考指标。

Study of diagnostic value of chemokine RANTES for primary hepatocellular carcinoma

Objective To identify the diagnostic value of chemokine regulated upon activation normal T cell ex- pressed and secreted（RANTES） in hepatocellular carcinoma（HCC） patients. Methods A total of 116 patients were enrolled in the study, amongst them, 35 cases were chronic hepatitis B, 34 cases were liver cirrhosis and 47 cases were HCC related to hepatitis B virus. The serum levels of chemokine RANTES were detected by the Luminex technique. Results The level of RANTES in the HCC patients [（23.27＋21.16）ng/ml] was significantly higher than that in chronic hepatitis B patients and liver cirrhosis cases [（7.81 ~4.06）ng/ml,（5.36~6.13）ng/ml, P 〈 0.001]. The level of RANTES in stage II HCC patients was higher than that in stage I cases[（31.94＋25.94）ng/ml vs. （14.24_＋8.10）ng/ml,P = 0.004]. The thresholds of RANTES for predicting chronic hepatitis B, liver cirrhosis progressing to HCC was 7.85 ng/ml, sensitivity of diagnosis was 93.5% and specificity was 72.5%. Conclusion A high level of RANTES is identified in HCC patients.Comparing with chronic hep- atitis B and liver cirrhosis patients, the level of RANTES increases with the progression of HCC. This finding indicates RANTES may serve as an index for diagnosis and evaluation of HCC.