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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 于明暉(Ming-Whei Yu) | |
dc.contributor.author | Pei-Chi Lu | en |
dc.contributor.author | 呂珮綺 | zh_TW |
dc.date.accessioned | 2021-06-16T05:41:13Z | - |
dc.date.available | 2019-10-20 | |
dc.date.copyright | 2014-10-20 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-08-12 | |
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Shen Q, Fan J, Yang XR, et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study. Lancet Oncol 2012; 13:817-826. 27. Sullivan PM, Etzioni R, Feng Z, et al. Phases of biomarker development for early detection of cancer. J Natl Cancer Inst 2001; 93:1054-1061. 28. Yu MW, Yeh SH, Chen PJ, et al. Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: a prospective study in men. J Natl Cancer Inst 2005; 97:265-272. 29. Shih WL, Chang HC, Liaw YF, et al. Influences of tobacco and alcohol use on hepatocellular carcinoma survival. Int J Cancer 2012; 131:2612-2621. 30. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334(11):693-699. 31. Prati D, Taioli E, Zanella A, et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med 2002; 137:1-10. 32. Iloeje UH, Yang HI, Su J, et al. Predicting cirrhosis risk based on the level of circulating hepatitis B viral load. Gastroenterology 2006; 130:678-686. 33. Alagiozian-Angelova V1, Alagiozian D, Antonov K, Krustev Z, et al. Clinical significance of serum HBeAg and HBV-DNA-specific values of virus replication in chronic hepatitis-B virus infection. Folia Med 1998; 40(4):34-41. 34. Llovet JM, Di Bisceglie AM, Bruix J, et al. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 2008; 100: 698-711. 35. Mountain CF. A new international staging system for lung cancer. Chest 1986; 89:225S-233S. 36. Klaus A, Birchmeier W. Wnt signalling and its impact on development and cancer. Nature Rev. Cancer 2008; 8:387-398. 37. Sunaga N1, Kohno T, Yokota J. Wnt signaling abnormalities in human lung cancer. Nihon Rinsho 2002; 60:733-736. 38. Shiina H1, Igawa M, Shigeno K, et al. 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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/56671 | - |
dc.description.abstract | 背景與目的:Alpha胎兒蛋白(AFP)為目前最廣泛用於肝癌監測的生物標記,但其敏感度有限,因此需要找敏感度更好的生物標誌物來增強肝癌的篩檢。Dickkopf-1(DKK1)是Wingless(WNT)致癌途徑的抑制蛋白。先前研究發現血清DKK1在肝癌的診斷上效果比AFP更佳。我們的研究有兩個目的: 第一,使用病例對照研究重新評估血漿DKK1是否能成為B型肝炎(HBV)帶原者的肝癌診斷生物標記;第二,使用重疊病例對照研究評估血漿DKK1是否能用於B型肝炎帶原者之肝癌早期檢測生物標記。
材料與方法:重疊病例對照研究包括151個肝癌患者與361個經過配對的對照,他們是來自於1988年起徵募共4841名年齡大於30歲的男性HBV帶原者世代中之個案。病例對照研究包括303個徵募於多醫學中心臨床研究的肝癌臨床個案,並以重疊病例對照研究中的361個非肝癌個案作為對照組。血漿DKK1濃度利用酵素免疫分析法方法測定,而DKK1對於肝癌的診斷和早期檢測準確度則利用接收器運作指標曲線的曲線下面積(AUC-ROC)來計算。 結果:在病例對照研究中,血漿DKK1對肝癌診斷的總AUC值為0.5146 (P=0.218)。當患者依照肝癌期別分為早期肝癌與晚期肝癌之後,診斷肝癌的AUC值分別為0.4882 (P=0.5288)和0.5654 (P=0.0026)。在重疊病例對照研究中,血漿DKK1與肝癌有負向相關,調整年齡、ALT、HBV DNA之後,DKK1濃度第三分位數與第四分位數的odds ratio (OR)分別為0.40 (95%信賴區間:0.21~0.77)與0.46 (95%信賴區間:0.24~0.86)。在肝癌早期檢測方面,DKK1對於全部肝癌的AUC值為0.6107 (P=0.0064),而當診斷出肝癌與血液抽取時間間隔區分成四組(即3年內、4-6年、7-9年、10-12年)之後,DKK1檢測肝癌之AUC值分別為0.5434 (P=0.9489)、0.6506 (P=0.0033)、0.6504 (P=0.0208)及0.5853 (P=0.2988)。 結論:血漿DKK1對於肝癌的診斷與早期檢測的準確性不佳,但它可能可以作為肝癌風險評估之生物標記。 | zh_TW |
dc.description.abstract | Background and aims: α-fetoprotein (AFP) has been widely used as a biomarker for hepatocellular carcinoma (HCC) surveillance, but it has limited sensitivity. Finding more sensitive biomarkers for HCC surveillance is needed. Dickkopf-1 (DKK1) is an inhibitory protein involved in Wingless oncogenic pathways. A previous study has shown that serum DKK1 is a better biomarker than AFP for the diagnosis of HCC. Our specific aims of this study were twofold: 1) Using the case-control study design to reevaluate whether plasma DKK1 could be used as a biomarker for diagnosis of HCC in hepatitis B virus (HBV) carriers; and 2) Using the nested case-control study design to assess whether plasma DKK1 could be used for early detection of HCC in HBV carriers.
Materials and Methods: The nested case-control study included a total of 151 HCC cases and 361 matched controls recruited from a cohort study of 4841 male HBV carriers initiated since 1988. For conducting case-control study, a case series of 303 clinical patients with HCC was recruited from a published multicenter study compared with the 361 HCC-free controls in the nested case-control study. Plasma DKK1 levels were measured by using Enzyme-Linked Immunosorbent Assay (ELISA). We need area under the curve of receiver operating characteristic (AUC-ROC) analysis to calculate the accuracy of DKK1 for diagnosis and screening of HCC. Results: In the case-control study, the overall AUC of DKK1 for the diagnosis of HCC was 0.5146 (P=0.218). When patients were classified as early and late–stage HCC, the AUC was 0.4882 (P=0.5288) for early stage and 0.5654 (P=0.0026) for late stage. In the nested case-control study, there was a negative association between plasma DKK1 and HCC, showing the odds ratios of 0.40 (95% confidence interval: 0.21 to 0.77) and 0.46 (95% confidence interval: 0.24 to 0.86), respectively, for the third and fourth quartile level of DKK1 relative to the first quartile level after adjustment for age, alanine aminotransferase and HBV DNA. The overall AUC of DKK1 for early detection of HCC was 0.6107 (P=0.0064). When the subjects who subsequently developed HCC were stratified into four groups (i.e., 0-3, 4-6, 7-9, and 10-12 years) according to the interval between blood draw and HCC diagnosis, the AUCs for the four groups of cases vs. controls were 0.5434 (P=0.9489), 0.6506 (P=0.0033), 0.6504 (P=0.0208) and 0.5853 (P=0.2988), respectively. Conclusion: The accuracy of plasma DKK1 was poor for either diagnosis or screening of HCC. However, plasma DKK1 may be used as a marker for the risk assessment of HCC. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T05:41:13Z (GMT). No. of bitstreams: 1 ntu-103-R01849028-1.pdf: 492162 bytes, checksum: 9a2131d0e4feb30eaa15cae6707e4b7d (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 前言 (1)
材料與方法 (6) 結果 (10) 討論 (14) 參考文獻 (18) | |
dc.language.iso | zh-TW | |
dc.title | 評估血漿Dickkopf-1做為肝癌診斷與篩檢之蛋白質標記 | zh_TW |
dc.title | Evaluation of Plasma Dickkopf-1 as a Protein Marker for the Diagnosis and Screening of Hepatocellular Carcinoma | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 莊雅惠(Ya-Hui Chuang) | |
dc.contributor.oralexamcommittee | 王姿乃,楊雅倩,林志陵 | |
dc.subject.keyword | B型肝炎病毒,肝細胞癌,DKK1(Dickkopf-1),診斷,早期檢測, | zh_TW |
dc.subject.keyword | HBV,HCC,DKK1 (Dickkopf-1),diagnosis,early detection, | en |
dc.relation.page | 36 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2014-08-12 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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