本文已被：浏览 41次 下载 62次
Received:October 23, 2023 Published Online:June 20, 2024
Received:October 23, 2023 Published Online:June 20, 2024
中文摘要: 目的 探讨血清辅肌动蛋白4（actinin-4）、三叶因子1（TFF1）、转化生长因子β诱导蛋白（TGFBI）对原发性肝癌（PHC）患者经导管动脉化疗栓塞（TACE）术后预后的预测价值。方法 以2020年1月至2023年5月在石家庄市人民医院进行TACE治疗的312例PHC患者为研究对象（PHC组），根据患者术后情况将PHC患者分为预后良好组（n=252）和预后不良组（n=60），另选取同期行健康检查者312例为对照组。ELISA法测定所有受试者血清actinin-4、TFF1、TGFBI水平。Logistic回归分析PHC患者TACE术后预后不良的影响因素；受试者工作特征曲线（ROC）分析血清actinin-4、TFF1、TGFBI对PHC患者TACE术后预后不良的预测价值。结果 预后良好组与预后不良组在性别、年龄、Child-Pugh分级及临床分期上差异无统计学意义（P＞0.05），在肿瘤大小、门静脉癌栓上差异有统计学意义（P＜0.05）。与对照组相比，PHC组患者血清actinin-4［（45.67±10.23） pg/mL vs （28.25±6.96）pg/mL, t=24.868, P＜0.01］、TFF1［（5.04±1.53） ng/mL vs （2.32±0.64） ng/mL, t=28.969, P＜0.01］、TGFBI［（19.16±4.36） ng/mL vs （10.25±2.43） ng/mL, t=31.530, P＜0.01］水平更高。与预后良好组相比，预后不良组患者血清actinin-4、TFF1、TGFBI水平均显著升高（P＜0.01）。多因素logistic回归分析结果显示，肿瘤大小、门静脉癌栓、血清actinin-4、TFF1、TGFBI均为PHC患者TACE术后预后的影响因素（P＜0.05）。ROC曲线结果显示，血清actinin-4、TFF1、TGFBI联合预测PHC患者TACE术后预后的AUC为0.926，敏感度为81.3%，特异度为76.8%。结论 PHC患者TACE术后预后不良患者血清actinin-4、TFF1、TGFBI水平均显著升高，且三者联合测定对患者预后具有良好的预测价值。
中文关键词: 原发性肝癌 动脉化疗栓塞术 辅肌动蛋白4 三叶因子1 转化生长因子β诱导蛋白
Abstract:Objective To investigate the predictive value of serum actinin-4, trefoil factor 1 (TFF1), and transforming growth factor-β-induced protein (TGFBI) for the prognosis of patients with primary hepatocellular carcinoma (PHC) after transarterial chemoembolization (TACE). Methods From January 2020 to May 2023, 312 patients with PHC who underwent TACE in Shijiazhuang People's Hospital were collected as the study subjects (PHC group), patients with PHC were separated into a group with good prognosis (n=252) and a group with poor prognosis (n=60) based on their postoperative conditions. And 312 subjects who underwent health examinations were selected as the control group. Serum levels of actinin-4, TFF1, and TGFBI were detected by ELISA. Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with PHC after TACE. Receiver operating characteristic curve (ROC) was applied to analyze the predictive value of serum actinin-4, TFF1, and TGFBI for poor prognosis after TACE in patients with PHC. Results There was no significant difference in gender, age, Child-Pugh grade, and clinical stage between the group with good prognosis and the group with poor prognosis (P＞0.05), but there were statistically differences in tumor size and portal vein tumor thrombus (P＜0.05). Compared with control group, the serum levels of actinin-4 ［(45.67±10.23) pg/mL vs (28.25±6.96) pg/mL, t=24.868, P＜0.01］, TFF1 ［(5.04±1.53) ng/mL vs (2.32±0.64) ng/mL, t=28.969, P＜0.01］, TGFBI ［(19.16±4.36)ng/mL vs (10.25±2.43) ng/mL, t=31.530, P＜0.01］ were obviously higher in PHC group. Compared with the group with good prognosis, the serum levels of actinin-4, TFF1, and TGFBI in the group with poor prognosis were obviously increased (P＜0.01). The results of multivariate logistic regression analysis showed that tumor size, portal vein tumor thrombus, serum actinin-4, TFF1, and TGFBI were all influencing factors for poor prognosis of PHC patients after TACE (P＜0.05). ROC curve results showed that the combined prediction of serum actinin-4, TFF1, and TGFBI for poor prognosis after TACE in PHC patients had an AUC of 0.926, a sensitivity of 81.3%, and a specificity of 76.8%. Conclusion The serum levels of actinin-4, TFF1, and TGFBI in patients with poor prognosis after TACE for PHC are obviously increased, and the combined determination of the three has good predictive value for prognosis of patients.
keywords: Primary hepatocellular carcinoma Transarterial chemoembolization Actinin-4 Trefoil factor 1 Transforming growth factor-β-induced protein
文章编号： 中图分类号：R735.7 文献标志码：A
基金项目:河北省医学科学研究课题计划项目（20231595）
引用文本：