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Objective:To investigate the diagnostic and differential diagnosis value of bone morphogenetic protein 2(BMP2)、bone morphogenetic protein 4(BMP4) on primary hepatic carcinoma(PHC) by analysis of their expression in the serum of patients with chronic liver disease.Methods:Serum of 60 patients were overviewed among which there were18 chronic hepatitis,17 hepatic cirrhosis and 25 primary hepatic carcinoma according to their pathologic diagnosis or clinical diagnosis.Serum of 9 normal donors were enrolled in this study as normal control. The feature of BMP2 and BMP4 expression was studied by enzyme-linked immunosorbentassay. Using radioimmunoassay to determine the density of AFP in serum in the PHC group.Results:①In group of hepatic carcinoma, the serum levels of BMP2 were lower than those in normal control chronic and hepatitis and hepatic cirrhosis. Differences in BMP2 expression were found between groups hepatic carcinoma and others (P＜0.05).②In group of hepatic carcinoma, the serum levels of BMP4 were lower than those in normal control and chronic hepatitis and hepatic cirrhosis. Differences in BMP4 expression were found between group hepatic carcinoma and others (P＜0.01), in group of chronic hepatitis, the serum levels of BMP4 were higher than those in normal control and hepatic cirrhosis. Differences in BMP4 expression were found between groups chronic hepatitis and the others (P＜0.01).③Using the lower limit of non-PHC 148.95pg/ml as the positive threshold limit value (TLV) For BMP2 in the diagnosis of PHC, the sensitivity and veracity respectively were 92.00% (23/25)and 97.10%(67/69), Using the lower limit of non-PHC 23.73pg/ml as the positive TLV for BMP4 in the diagnosis of PHC, the sensitivity and veracity respectively were 80.00%(20/25) and 92.75%(64/69),Using 20ug/L as the positive TLV for AFP, the sensitivity and veracity respectively were 68.00%(17/25) and 69.57%(48/69)④Using the chi-square test compare the sensitivity of BMP2、BMP4 and AFP to diagnosis the PHC, compare BMP2 and AFP,x2=15.57,P=0.001, compare BMP4 and AFP,x2=29.64,P=0.001, compare BMP2 and BMP4,x2=0.8,P=0.375, (P＞0.05)⑤Using the Spearman rank correlation to correlation analysis the BMP2 and AFP of each group, and find there is no correlation(r= 0.315, P=0.235),analysising the BMP4 and AFP of each group, and also there is no correlation (r= 0.517, P=0.299)Conclusion:There is significant difference comparing the BMP2,BMP4 of hepatocellular carcinoma patients’to the normal donors,chronic hepatitis and hepatic cirrhosis,this means BMP2 and BMP4 may be involved in PHC’s occurrence and development.Compare BMP2, BMP4 to the traditional tumor markers AFP, we find the sensitivity, specificity and accuracy is higher than the AFP, So detection of BMP2 and BMP4 can improve the diagnostic sensitivity and specificity. Detection of BMP2 and BMP4 in the differenct groups, we find BMP2 and BMP4 in the serum can be used to diagnosis PHC,and differential diagnosis of PHC with chronic hepatitis and hepatic cirrhosis.
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