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目的观察肝硬化、原发性肝癌患者肝组织和血清中胰岛素样生长因子结合蛋白-5(IGFBP-5)水平,探讨其与肝硬化、原发性肝癌的关系及其临床意义。方法取肝硬化组织、肝癌组织及癌旁正常组织各8例,采用实时RT-PCR技术检测IGFBP-5mRNA的表达水平;取肝硬化(21例)、原发性肝癌(14例)及正常对照者(14例)血清,采用ELISA法检测IGFBP-5水平,分析IGFBP-5在不同分组中水平的差异及其临床意义。结果肝硬化组肝组织中IG-FBP-5mRNA的表达及血清中IGFBP-5水平均较正常对照组降低(P均<0.05),与血清中升高的透明质酸(HA)、层粘连蛋白(LN)和肝功能无相关性。原发性肝癌组肝组织中IGFBP-5的表达及血清中IGFBP-5水平均高于正常对照组和肝硬化组(P均<0.05),与血清中升高的甲胎蛋白(AFP)和肝功能亦无相关性。结论在肝硬化发生后,肝组织表达和合成IGFBP-5减少,与其他细胞因子的调节有关,其可能与HA、LN互补作为诊断早期肝纤维化的一个无创指标;原发性肝癌患者肝组织中IGFBP-5表达增多,血清水平增高,其有可能作为一个潜在的诊断原发性肝癌的检测指标。IGFBP-5与肝硬化、原发性肝癌的关系值得进一步研究。
Objective To observe the levels of insulin-like growth factor binding protein-5 (IGFBP-5) in liver cirrhosis and primary liver cancer patients and explore its relationship with cirrhosis and primary liver cancer and its clinical significance. Methods The expression of IGFBP-5 mRNA was detected by real-time RT-PCR in 8 cases of cirrhosis, hepatocellular carcinoma and adjacent normal tissues. Liver cirrhosis (21 cases), primary hepatocellular carcinoma (14 cases) and normal control (14 cases), the level of IGFBP-5 was measured by ELISA, and the difference of IGFBP-5 in different groups was analyzed and its clinical significance was analyzed. Results The expression of IG-FBP-5 mRNA and the level of IGFBP-5 in serum of cirrhosis group were lower than those of normal control group (all P <0.05), and were significantly correlated with elevated serum hyaluronic acid (HA), laminin (LN) and liver function no correlation. The expression of IGFBP-5 and the level of IGFBP-5 in serum of patients with primary hepatocellular carcinoma were significantly higher than those of normal controls and cirrhosis patients (all P <0.05) There is no correlation between liver function. Conclusions After liver cirrhosis, the expression of IGFBP-5 and the decrease of IGFBP-5 in liver tissue are related with the regulation of other cytokines, which may be complementary to HA and LN as a non-invasive index in the diagnosis of early liver fibrosis. The liver tissue of patients with primary liver cancer IGFBP-5 expression increased, serum levels increased, it may be used as a potential diagnostic indicator of primary liver cancer. The relationship between IGFBP-5 and cirrhosis and primary liver cancer deserves further study.