肝癌患者消融治疗后血浆可溶性程序性细胞死亡蛋白1的变化及其与预后的关系  

Changes of plasma soluble programmed cell death protein 1 after ablation therapy and its effect on the prognosis of patients with liver cancer

作　　者：张伟明 臧超然 覃岭 孙坚萍 李康 李昂 王文静[1] 张永宏[2] 赵艳[1] Weiming;Zang Chaoran;Qin Ling;Sun Jianping;Li Kang;Li Ang;Wang Wenjing;Zhang Yonghong;Zhao Tan(Clinical Examination Center,Beijing Youan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京佑安医院临检中心,100071 [2]首都医科大学附属北京佑安医院肿瘤介入治疗中心,100071 [3]首都医科大学附属北京佑安医院生物医学信息中心,100071

出　　处：《北京医学》2022年第3期232-235,240,共5页Beijing Medical Journal

基　　金：首都卫生发展科研专项(首发2020-1-2182)。

摘　　要：目的探讨肝癌患者血浆可溶性程序性细胞死亡蛋白1(soluble programmed cell death protein 1,sPD-1水平和消融治疗后sPD-1变化与肝癌患者预后的关系。方法选取2017年1月至2018年12月首都医科大学附属北京佑安医院收治的原发性肝癌患者30例,采用液相芯片技术检测患者消融治疗前和治疗后1周以及42例健康体检成人血浆sPD-1水平。比较肝癌患者治疗前和治疗后1周血浆sPD-1水平,并分析sPD-1变化与肝癌患者治疗后1年复发的关系。结果肝癌组消融治疗前血浆sPD-1水平明显高于健康对照组[(44.19±25.55)pg/ml比(24.33±6.29)pg/ml],差异有统计学意义(t=–4.849,P=0.000);肝癌组消融治疗后1周血浆sPD-1水平降低为(35.55±16.62)pg/ml,明显低于治疗前,差异有统计学意义(t=–2.149,P=0.040)。其中17例血浆sPD-1水平与治疗前相比降低,13例与治疗前相比不变或升高。消融治疗后sPD-1降低组巴塞罗那临床肝癌(Barcelona clinic liver cancer,BCLC)分期主要为0/A期,而sPD-1不变或升高组BCLC分期主要为B/C期(P=0.025)。消融治疗后1周sPD-1不变或升高组患者1年累计复发率高于sPD-1降低组患者(83.3%比48.9%),差异有统计学意义(χ^(2)=4.030,P=0.045)。结论肝癌患者血浆sPD-1水平升高,消融治疗后1周血浆sPD-1水平发生变化,且sPD-1变化与患者消融治疗后1年复发相关,有望作为肝癌早期复发的预测标志物。Objective To investigate the effect of ablation therapy on the plasma level of soluble programmed cell death protein 1(sPD-1)in patients with liver cancer,as well as its changes with the prognosis of patients.Methods A total of30 patients with primary liver cancer admitted to Beijing Youan Hospital,Capital Medical University from January 2017 to December 2018 were selected.The plasma sPD-1 levels of patients before and one week after ablation therapy and 42 healthy adults were detected by liquid chip technology.The relationship between sPD-1 changes and the recurrence of liver cancer at one year after treatment was analyzed.Results Before ablation,the level of plasma sPD-1 in liver cancer group was significantly higher than that in healthy control group[(44.19±25.55)pg/ml vs.(24.33±6.29)pg/ml],the difference was statistically significant(t=–4.849,P=0.000).One week after ablation,the level of plasma sPD-1 in liver cancer group decreased to(35.55±16.62)pg/ml,which was significantly lower than that before treatment,the difference was statistically significant(t=–2.149,P=0.040).The level of plasma sPD-1 decreased in 17 cases and unchanged or increased in 13 cases compared with that before treatment.After ablation,the Barcelona clinic liver cancer(BCLC)stage in the decreased sPD-1group was mainly 0/A,while the BCLC stage in the unchanged or increased sPD-1 group was mainly B/C(P=0.025).The one-year cumulative recurrence rate in the unchanged or increased sPD-1 group was higher than that in the decreased sPD-1 group(83.3%vs.48.9%,χ^(2)=4.030,P=0.045).Conclusions The level of plasma sPD-1 in patients with liver cancer increases.The level changes of plasma sPD-1 one week after ablation therapy are correlated with recurrence one year after ablation treatment.

关 键 词：肝癌 消融治疗 可溶性程序性细胞死亡蛋白1 预后 

分 类 号：R735.7[医药卫生—肿瘤]