血清Sema4D、BMP-4、AFU与乙肝相关肝癌患者临床病理特征及预后的关系  

The relationship between serum Sema4D,BMP-4,AFU and clinicopathological characteristics and prognostic survival of patients with hepatitis B related liver cancer

作　　者：王桂玲 王治海 张香玲 尹生兰 WANG Guiling;WANG Zhihai;ZHANG Xiangling;YI Shenglan(Clinical Laboratory, People's Hospital of Haixi Autonomous Prefecture, Haixi 817099, China)

机构地区：[1]青海省海西自治州人民医院检验科,青海海西817099

出　　处：《中国肿瘤外科杂志》2021年第2期185-190,共6页Chinese Journal of Surgical Oncology

摘　　要：目的研究乙肝相关原发性肝癌(PHC)患者血清轴突导向因子4D(Sema4D)、骨形成蛋白4(BMP-4)、α-L-岩藻糖苷酶(AFU)水平与临床病理特征及预后生存情况的关系。方法选取青海省海西自治州人民医院2015年1月至2017年1月收治的乙肝相关PHC患者120例、乙肝肝硬化患者60例、慢性乙肝患者60例及健康志愿者60例为对照组,比较4组的血清Sema4D、BMP-4、AFU水平,采用受试者工作特征曲线(ROC)分析Sema4D、BMP-4、AFU诊断乙肝相关PHC的临界值,分析血清Sema4D、BMP-4、AFU水平与乙肝相关PHC患者临床病理特征及预后生存时间的关系。结果对照组、慢性乙肝组、乙肝肝硬化组、乙肝相关PHC组的血清Sema4D、AFU水平呈逐级升高趋势(P<0.05);对照组的BMP-4水平高于乙肝肝硬化组和乙肝相关PHC组,低于慢性乙肝组,乙肝相关PHC组的BMP-4水平低于乙肝肝硬化组(P<0.05)。ROC曲线显示,Sema4D、BMP-4、AFU诊断乙肝相关PHC具有较好的临床价值,根据Sema4D、BMP-4、AFU诊断乙肝相关PHC的临界值9.5 ng/ml、31.4 pg/ml及67.2 U/L,将分为高水平组和低水平组,两组性别、年龄、肿瘤直径、肿瘤数目、乙型肝炎表面抗原(HBsAg)阳性率差异无统计学意义(P>0.05);两组TNM分期、Child-Pugh分级、是否侵犯血管、有无腹水差异有统计学意义(P<0.05)。不同性别、年龄、肿瘤直径、肿瘤数目、HBsAg阳性乙肝相关PHC患者的中位生存时间(MST)比较差异无统计学意义(P<0.05);不同TNM分期、Child-Pugh分级、是否侵犯血管、有无腹水及血清Sema4D、BMP-4、AFU水平乙肝相关PHC患者的MST比较差异有统计学意义(P<0.05)。多因素Cox回归分析显示,TNM分期Ⅲ、Ⅳ期、Child-Pugh分级B级、侵犯血管、血清Sema4D、AFU水平异常升高及BMP-4水平异常降低为乙肝相关PHC患者预后生存的独立危险因素(P<0.05)。结论PHC患者血清Sema4D、AFU水平升高、BMP-4水平降低,Sema4D、BMP-4、AFU与肿瘤发生发展�Objective To study the level of serum axon guiding factor 4D(Sema4D),bone morphogenetic protein 4(BMP-4),α-L-fucosidase(AFU)and clinicopathology in patients with hepatitis B-related primary liver cancer(PHC)The relationship between characteristics and prognosis and survival.Methods 120 patients with hepatitis B related PHC,60 patients with hepatitis B cirrhosis,60 patients with chronic hepatitis B,and 60 healthy volunteers who were admitted to the Haixi Autonomous Prefecture People's Hospital of Qinghai Province from January 2015 to January 2017 were selected as the control group.The serum levels of Sema4D,BMP-4,and AFU in the 4 groups were analyzed by receiver operating characteristic curve(ROC)to analyze the cut-off values of Sema4D,BMP-4,and AFU in the diagnosis of PHC related to hepatitis B.The levels of serum Sema4D,BMP-4,and AFU were analyzed with The relationship between clinicopathological characteristics and prognostic survival time of patients with hepatitis B-related PHC.Results The serum Sema4D and AFU levels of the control group,chronic hepatitis B group,hepatitis B cirrhosis group,and hepatitis B related PHC group showed a gradual increase trend(P<0.05).The BMP-4 level of the control group was higher than that of the hepatitis B cirrhosis group and hepatitis B related PHC group,and lower than the chronic hepatitis B group,and the BMP-4 level of the hepatitis B related PHC group was lower than the hepatitis B cirrhosis group(P<0.05).ROC curve showed that Sema4D,BMP-4,AFU have good clinical value in diagnosing PHC related to hepatitis B.According to Sema4D,BMP-4,AFU diagnosis of hepatitis B related PHC cut-off values of 9.5 ng/ml,31.4 pg/ml and 67.2 U/L are divided into high-level group and low-level group,two groups of gender,age,tumor diameter,tumor number There was no significant difference in the positive rate of HBsAg(P>0.05);there were significant differences in TNM staging,Child-Pugh classification,blood vessel invasion,and ascites between the two groups(P<0.05).There was no statistically sign

关 键 词：乙肝相关肝癌 轴突导向因子4D 骨形成蛋白4 Α-L-岩藻糖苷酶 

分 类 号：R73[医药卫生—肿瘤]