肝细胞癌病人血清微量元素和氨基酸变化的观察研究

摘要/Abstract

摘要：

目的：探讨肝细胞癌（HCC）病人血清微量元素及氨基酸谱的变化特点，为临床诊治提供参考依据。方法：选取本院2024年1月至2024年4月期间肝胆外科手术治疗的HCC病人104例作为研究组，另选取同期139例胆道良性疾病病人作为对照组。采用火焰原子吸收光谱法检测两组血清中铜、锌、钙、镁、铁和铅6种微量元素含量，用液相色谱串联质谱法检测21种氨基酸水平。结果：与对照组相比，HCC组血清中铜水平明显升高（P<0.05），而锌、铁水平明显降低（P<0.05）。氨基酸谱分析发现，与对照组相比，HCC组酪氨酸、甲硫氨酸及苯丙氨酸水平升高（P<0.05），而缬氨酸、亮氨酸、异亮氨酸、谷氨酰胺及精氨酸水平降低（P<0.05）。对组间有统计学差异的微量元素和氨基酸进一步分析两者间相关性，铜与缬氨酸、亮氨酸之间存在负相关（P<0.05）；而锌、铁与缬氨酸、亮氨酸及异亮氨酸之间均存在显著正相关（P<0.01）。结论：HCC病人普遍存在微量元素失衡和氨基酸代谢改变现象，且二者可能存在一定的内在联系。

关键词:肝细胞癌,微量元素,氨基酸

Abstract:

ObjectiveTo explore the changes in trace elements and amino acid profiles in serum of patients with hepatocellular carcinoma(HCC) providing a reference for clinical diagnosis and treatment.MethodsA total of 104 patients with HCC who underwent surgical treatment in the Department of Hepatobiliary Surgery of our hospital from January 2024 to April 2024 were selected as the study group, and 139 patients with benign biliary diseases during the same period were selected as the control group. Atomic absorption spectrometry was used to detect the levels of six trace elements (copper, zinc, calcium, magnesium, iron, and lead) in the serum of both groups, and liquid chromatography-tandem mass spectrometry was used to measure the concentrations of 21 amino acids.ResultsCompared with the control group, the serum copper level in the HCC group was significantly increased (P<0.05), while the levels of zinc and iron were significantly decreased (P<0.05). Amino acid profile analysis revealed that, compared with the control group, the concentrations of tyrosine, methionine, and phenylalanine in the HCC group were increased (P<0.05), while the concentrations of valine, leucine, isoleucine, glutamine, and arginine were decreased (P<0.05). Further analysis of the correlation between trace elements and amino acids with statistical differences between the groups showed that copper was negatively correlated with valine and leucine (P<0.05), while zinc and iron were positively correlated with valine, leucine, and isoleucine (P<0.01).ConclusionsImbalances in trace elements and amino acid metabolism changes are common in patients with HCC, and there may be an intrinsic connection between the two.

Key words:Hepatocellular carcinoma(HCC),Trace element,Amino acid

中图分类号:

罗茜, 蒋咏梅, 马迪, 陆秋涯, 顾晓寒. 肝细胞癌病人血清微量元素和氨基酸变化的观察研究[J]. 外科理论与实践, 2025, 30(2): 146-150.

LUO Xi, JIANG Yongmei, MA Di, LU Qiuya, GU Xiaohan. Observation on changes of trace elements and amino acids in serum of patients with hepatocellular carcinoma[J]. Journal of Surgery Concepts & Practice, 2025, 30(2): 146-150.

图/表3

Trace elements	Control Group (n=139)	HCC Group (n=104)	tvalue	Pvalue
Cu	15.2 ± 2.5	17.1 ± 3.7	4.59	<0.01
Zn	92.1 ± 13.1	87.8 ± 11.5	-2.71	<0.01
Ca	1.4 ± 0.1	1.4 ± 0.1	0.00	0.92
Mg	1.5 ± 0.1	1.5 ± 0.1	-0.64	0.52
Fe	8.1 ± 0.9	7.7 ± 1.1	-2.48	<0.05
Pb	16.8 ± 16.2	23.3 ± 62.3	1.04	0.24

表1

表2

两组血清氨基酸水平比较（x±s，μmol/L）

Amino acid	Control group (n=139)	HCC group (n=104)	tvalue	Pvalue
Glut	77.2 ± 35.5	84.8 ± 40.5	1.52	0.12
Asp	6.1 ± 1.7	6.5 ± 2.0	1.37	0.16
Asn	46.3 ± 7.8	47.1 ± 10.4	0.72	0.46
Ser	132.1 ± 28.9	134.7 ± 34.7	0.63	0.52
Lys	194.4 ± 35.0	182.3 ± 34.5	-2.69	0.08
Trp	50.8 ± 9.3	52.4 ± 13.3	0.98	0.30
Phe	63.2 ± 9.6	70.3 ± 13.1	4.68	<0.01
Met	24.8 ± 4.7	29.4 ± 8.2	5.10	<0.01
Thr	138.3 ± 36.1	144.6 ± 39.9	1.27	0.20
Leu	134.3 ± 26.2	115.2 ± 28.2	-5.39	<0.01
Ile	81.1 ± 19.1	72.6 ± 16.1	-3.78	<0.01
Val	264.2 ± 49.8	245.6 ± 54.0	-2.74	<0.05
Arg	63.4 ± 17.2	53.9 ± 18.1	-4.16	<0.01
Tyr	64.2 ± 12.3	79.0 ± 23.1	5.94	<0.01
His	86.8 ± 11.9	84.0 ± 15.0	-1.50	0.12
Orn	111.1 ± 35.3	113.1 ± 30.4	0.49	0.63
Ala	409.0 ± 96.1	396.0 ± 107.4	-0.98	0.32
Pro	170.5 ± 52.7	178.6 ± 71.2	0.98	0.31
Cit	32.2 ± 9.5	34.8 ± 14.7	1.54	0.10
Gly	229.3 ± 58.8	240.9 ± 64.9	1.43	0.15
Gln	733.8 ± 130.8	640.7 ± 167.8	-4.69	<0.01
BCAA/AAA	3.0 ± 0.5	1.8 ± 0.8	-3.86	<0.05

表2

Correlation coefficient	Cu	Zn	Fe
Val	-0.146*	0.271^**	0.395^**
Met	-0.013	0.102	0.104
Ile	-0.064	0.180^**	0.252^**
Leu	-0.177^**	0.264^**	0.416^**
Tyr	0.016	0.121	0.173
Phe	0.026	0.122	0.105
Arg	-0.099	0.029	0.102
Gln	-0.122	-0.06	0.072

表3

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