The clinical significance of serum sialic acid detection for diagnosis and therapy monitoring in liver cancer patients / 中华检验医学杂志

ABSTRACT

Objective To investigate the clinical significance of the serum sialic acid (SA) detection for the diagnosis and therapy monitoring in liver cancer patients.Methods Patients and healthy people of Chinese academy of medical science cancer hospital from January 2011 to October 2012,were enrolled,including 221 liver cancer patients (183 primary hepatic carcinoma patients and 38 metastatic hepatic carcinoma patients),117 benign liver disease patients and 150 healthy people.The concentration of serum SA were tested by ROCHE P800.The intra-assay and inter-assay coefficient of variation (CV) of SA kit were evaluated by use of low and high concentration samples,measured for 5 days and 4 times each day.Receiver operating characteristic (ROC) curve were used to determine the cut-off of SA using data of 183 cases of primary liver cancer and 150 healthy controls.The area under the curve (ROC-AUC) were used to evaluate the diagnostic value of SA.The changes of serum SA level in 103 cases of primary hepatic carcinoma patients were monitored before therapy and at the 1 st day,7 th day,14 th day,1 st month,3rd month,6 th month and 9 th month after treatment.SPSS16.0 was used to analyse the results.Results The intra and inter-day CVs for low level sample were 2.4％ and 3.2％ respectively,and for high level sample were 2.2％ and 3.1％.The cut-off value of the serum SA was 659 mg/L for liver cancer,the sensitivity and specificity was 63.4％ (1 16/183) and 94.7％ (142/150) respectively.The serum SA level of liver cancer group [(726 ± 173) mg/L] was higher than that of liver benign disease patients group [(552 ± 128) mg/ L] and healthy controls group [(599 ± 62) mg/L,U values were 1832.52 and 887.00,P ＜ 0.01].The serum SA level were tracked in 103 cases of primary hepatic carcinoma patients during therapy period.The serum level of SA elevated to [(817 ± 193) mg/L,t =-3.272,P ＜ 0.05] at I st week after treatment and kept at high level until late in 1st month after treatment [(782 ±173) mg/L,t =-2.694,P＜0.05].In the 3rd month,the SA level decreased to that of pretreatment [(662 ± 138) mg/L,t =1.225,P ＞ 0.05].In the 6th months,the SA level declined to [(615 ± 144) mg/L,t =1.999,P ＜0.05],as well as the level of healthy control group.There were 85 cases of hepatic carcinoma patients with decreased SA level compared with that of pretreatment,and the coincidence rate was 82.5％ (85/103),the Kappa value was 0.79.There were 5 cases of patients with hepatic carcinoma relapse after treatment in 9 th months and the SA levels increased significantly to (939 ± 175) mg/L.Conclusion The serum SA has significant values possibly in the diagnosis and therapy monitoring in liver cancer patients.