血清GP73联合肝硬度值对原发性肝癌患者根治性切除术后预后评估的价值  

The value of serum GP73 combined with liver stiffness measurement in evaluating the prognosis of primary hepatic carcinoma after radical resection

作　　者：何凤霞 陈熙 尚亚婷 HE Feng-xia;CHEN Xi;SHANG Ya-ting(Mianyang Central Hospital,School of Medicine,University of Electronic Scienle and Technology of China(Mianyang,621000),China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院,四川绵阳621000

出　　处：《中西医结合肝病杂志》2022年第5期419-422,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：四川省卫生健康委员会科研课题(No.19PJ115)。

摘　　要：目的:检测血清高尔基体糖蛋白73(GP73)联合肝硬度值(LSM)对原发性肝癌(PHC)患者根治性切除术后预后评估的价值。方法:选择在本院就诊并进行根治性切除术治疗的PHC患者85例(PHC组),另选取同期健康体检人员85例作为对照组,根据术后患者复发情况将PHC患者分为未复发组37例和复发组48例。检测患者术前血清GP73表达水平,并检测各观察对象LSM,分析PHC患者GP73、LSM表达水平与临床病理特征关系,ROC曲线分析GP73、LSM对PHC患者术后复发的诊断价值,Kaplan-Meier分析PHC患者术后3年无进展生存情况。结果:与对照组比较,PHC患者根治性切除术前血清GP73、LSM水平显著升高(P<0.05);肿瘤直径≥40 mm、肝功能Child-Pugh分级B级、肿瘤远处转移和血管癌栓的PHC患者血清GP73、LSM水平较肿瘤直径<40 mm、肝功能Child-Pugh分级A级、无肿瘤远处转移和无血管癌栓的PHC患者增高(P<0.05);与未复发组患者比较,复发组患者血清GP73、LSM表达水平显著升高(P<0.05);血清GP73、LSM联合预测PHC患者术后复发的曲线下面积为0.925,敏感度为94.74%,特异度为77.08%;血清GP73≥361.49 ng/ml组患者3年无进展生存率显著低于血清GP73<361.49 ng/ml患者(52.14%vs 81.83%,P<0.05);LSM≥18.23 kPa组患者3年无进展生存率显著低于LSM<18.23 kPa组患者(52.75%vs 80.06%,P<0.05)。结论:血清GP73、LSM与PHC患者临床病理特征和预后有关,二者联合检测对PHC患者根治性切除术后预后评估具有一定价值。Objective:To detect the value of serum Golgi protein 73(GP73)combined with liver stiffness measurement(LSM)in evaluating the prognosis of patients with primary hepatic carcinoma(PHC)after radical resection.Methods:From March 2015 to September 2017,85 PHC patients(PHC group)who were treated with radical resection in our hospital were selected,and another 85 health people who were undergoing health examination were selected as the control group.Patients with PHC were divided into non recurrence group(n=37)and a recurrence group(n=48)according to the recurrence.The expression level of GP73 was detected by enzyme linked immunosorbent assay and LSM were also detected,the relationship between the expression levels of GP73 and LSM in PHC patients and their clinicopathological features was analyzed,ROC curve was used to analyzing the diagnostic value of GP73 and LSM for postoperative recurrence of PHC,and Kaplan-Meier was used to analyze the 3-year progression free survival of PHC patients.Results:Compared with those in the control group,the serum GP73 and LSM levels of PHC patients before radical resection was significantly higher(P<0.05);the serum GP73 and LSM levels of PHC patients with tumor diameter≥40 mm,liver function Child-Pugh grade B,tumor distant metastasis and vascular tumor thrombus were higher than those with tumor diameter<40 mm,liver function Child-Pugh grade A,non distant metastasis and non vascular tumor thrombus(P<0.05);compared with those in the non recurrence group,the serum GP73 and LSM expression levels in the recurrence group were significantly higher(P<0.05);the area under the curve of serum GP73 and LSM in predicting postoperative recurrence of PHC was 0.925,the sensitivity was 94.74%,and the specificity was 77.08%;the 3-year progression free survival rate of patients with serum GP73≥361.49 ng/mL was significantly lower than that of patients with serum GP73<361.49 ng/mL(52.14%vs 81.83%,P<0.05);the 3-year progression free survival rate of patients with LSM≥18.23 kPa was significantly lower

关 键 词：原发性肝癌 高尔基体糖蛋白73 根治性切除术 肝硬度值 预后 

分 类 号：R735.7[医药卫生—肿瘤]