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目的探讨肝细胞癌患者血浆TF,uPA和uPAR水平变化及临床病理意义。方法应用酶联免疫法(ELISA)检测肝细胞癌患者50例及对照组30例的血浆TF,uPA和uPAR水平并结合临床病理资料探讨其统计学意义。结果肝细胞癌患者血浆TF,uPA及uPAR均较对照组升高,差异有显著性(P<0.05)。肝细胞癌患者血浆TF在低分化组,肿瘤较大组及合并肝硬化组显著升高(P<0.05),而在不同癌灶数目及包膜情况组间差异无显著性(P>0.05)。血浆uPA水平只在合并肝硬化组升高(P<0.05),uPAR水平与以上病理指标均无关(P>0.05)。肝细胞癌患者血浆TF,uPA和uPAR水平均与侵袭转移指标有关,在有淋巴转移,肝外脏器转移及门脉癌栓组较无转移及癌栓组升高(P<0.05)。结论肝细胞癌患者存在凝血,纤溶激活状态。血浆TF,uPA和uPAR升高与肝细胞癌的发生及侵袭转移有关,其检测有助于肝癌早期诊断及预后判断。
Objective To investigate the changes of plasma levels of TF, uPA and uPAR in patients with hepatocellular carcinoma and their clinicopathological significance. Methods Serum levels of TF, uPA and uPAR in 50 patients with hepatocellular carcinoma and 30 patients in control group were detected by enzyme-linked immunosorbent assay (ELISA) and their clinical significance were analyzed. Results The levels of plasma TF, uPA and uPAR in patients with hepatocellular carcinoma were significantly higher than those in control group (P <0.05). Plasma TF in patients with hepatocellular carcinoma was significantly higher in the poorly differentiated group, the larger tumor group and the cirrhotic liver cirrhosis group (P <0.05), while there was no significant difference in the number of different cancerous lesions and the envelopment group (P> 0.05) . The level of plasma uPA only increased in patients with cirrhosis (P <0.05), and the level of uPAR had no correlation with the above pathological parameters (P> 0.05). The levels of plasma TF, uPA and uPAR in patients with hepatocellular carcinoma were both related to the invasion and metastasis, and there was an increase in lymph node metastasis, extrahepatic organ metastasis and portal vein thrombosis compared with no metastasis and tumor embolus (P <0.05). Conclusion There is coagulation and fibrinolytic activation in patients with hepatocellular carcinoma. Elevated plasma levels of TF, uPA and uPAR are associated with the occurrence and invasion and metastasis of hepatocellular carcinoma, which may be helpful for the early diagnosis and prognosis of hepatocellular carcinoma.