血清天冬氨酸-天冬酰胺β羟化酶表达与肝细胞癌术后患者预后的关系研究  

Correlation between Serum Aspartate Beta-hydroxylase and Prognosis of Patients with Hepatocellular Carcinoma after Surgery

作　　者：张继宗[1] 胡亮[1] 韩建波[1] 易永祥[1] 

机构地区：[1]东南大学附属南京市第二医院肝胆外科,江苏省南京市210003

出　　处：《中国全科医学》2016年第35期4350-4353,共4页Chinese General Practice

基　　金：江苏省第四期"333工程"项目(20140522);"十二五"南京市医学科技发展重大项目(20130231)

摘　　要：目的探讨血清天冬氨酸-天冬酰胺β羟化酶(ASPH)表达与肝细胞癌(HCC)术后患者复发或死亡的关系。方法选取2010年6月—2011年1月于东南大学附属南京市第二医院肝胆外科收治的HCC患者96例为研究对象,记录患者病理分级、肿瘤直径、肝纤维化病理分期、TNM分期,以及有无门静脉癌栓、微血管浸润,检测入院时清蛋白、总胆红素水平。检测术前甲胎蛋白(AFP)、高尔基体蛋白73(GP73),以及术前及术后1周、1个月、2个月ASPH水平。以手术时间为观察起点随访5年,以肿瘤复发或死亡为观察终点事件。分别采用Log-rank检验、多因素Cox比例风险回归模型分析HCC术后患者预后的影响因素。结果 HCC患者术前及术后1周、1个月、2个月ASPH水平分别为(128.3±19.3)、(91.2±16.2)、(33.7±9.4)、(22.4±5.7)ng/L,术后2个月患者ASPH水平均在参考范围内。单因素分析显示,不同肿瘤直径、TNM分期,有无门静脉癌栓、微血管浸润,以及不同术前ASPH表达的HCC术后患者复发或死亡率比较,差异均有统计学意义(P<0.05)。多因素Cox比例风险回归模型分析显示,TNM分期〔HR=1.378,95%CI(1.124,1.842)〕、门静脉癌栓〔HR=1.260,95%CI(1.012,1.356)〕、微血管浸润〔HR=1.583,95%CI(1.144,2.652)〕、术前ASPH表达〔HR=1.475,95%CI(1.875,2.011)〕是HCC术后患者复发或死亡的影响因素(P<0.05)。结论术前ASPH表达是HCC术后患者复发或死亡的独立影响因素,可作为判断HCC术后患者预后的潜在指标。Objective To investigate the correlation between serum aspartate beta- hydroxylase（ ASPH） and recurrence or death of patients with hepatocellular carcinoma（ HCC） after surgery. Methods 96 HCC patients after surgery who were treated in Department of Hepatobiliary Surgery in Nanjing Second Hospital Affiliated to Southeast University from June 2010 to January 2011,were selected as study subjects. The pathological grading,tumor diameter,pathological stage of liver fibrosis,TNM staging,presence of portal vein tumor thrombus and microvascular invasion of patients were recorded,levels of albumin and total bilirubin after admission were detected. Levels of AFP,GP73 and ASPH were detected before surgery,level of ASPH was detected 1 week,1 month and 2 months after surgery respectively. The patients were followed up for 5 years since surgery,and endpoints were recurrence or death. Log- rank test and multivariate Cox proportional hazard regression model were used to analyze the influencing factors of the prognosis of HCC patients after surgery. Results ASPH express level of HCC patients before surgery,1 week,1 month and 2 months after surgery was（ 128. 3 ± 19. 3） ng / L,（ 91. 2 ± 16. 2） ng / L,（ 33. 7 ± 9. 4）ng / L,and（ 22. 4 ± 5. 7） ng / L respectively,ASPH level of HCC patients 2 months after surgery was within the reference range.According to univariate analysis results,there were significant differences in incidence of recurrence or death among HCC patients after surgery with different tumor diameter,TNM staging,ASPH express level before surgery,between patients with portal vein tumor thrombus or not,between patients with microvascular invasion or not（ P〈0. 05）. According to results of multivariate Cox proportional hazard regression model,TNM staging [HR = 1. 378,95% CI（ 1. 124,1. 842） ],portal vein tumor thrombus[HR = 1. 260,95% CI（ 1. 012,1. 356） ],microvascular invasion [HR = 1. 583,95% CI（ 1. 144,2. 652） ],and ASPH express level [HR = 1. 475,95% CI（ 1. 875,2. 011） ]we

关 键 词：癌 肝细胞 天冬氨酸-天冬酰胺β羟化酶 肿瘤复发 预后 

分 类 号：R730.261[医药卫生—肿瘤]