血清MMP-9、HIF-1α水平与肝癌患者TACE治疗疗效和预后的关系研究  

Relationship Between Serum MMP-9,HIF-1αLevels and TACE Treatment Efficacy and Prognosis in Patients with Liver Cancer

作　　者：刘光辉 张其润 邱福轩 LIU Guanghui;ZHANG Qirun;QIU Fuxuan(Central Hospital,Jiaozuo Coal Industry(Group)Co,LTD,Jiaozuo,454000)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院,454000

出　　处：《实用癌症杂志》2023年第7期1097-1100,共4页The Practical Journal of Cancer

摘　　要：目的探讨血清基质金属蛋白酶-9(MMP-9)、低氧诱导因子(HIF-1α)水平与肝细胞癌(HCC)患者肝动脉插管化疗栓塞(TACE)治疗疗效和预后的关系。方法选取接受TACE治疗的HCC患者74例,根据mRECIST疗效标准,将其分为有效组(肿瘤缩小或保持稳定状态)49例和无效组(肿瘤未缩小甚至加重)25例。检测治疗前后HCC患者血清MMP-9、HIF-1α水平,采用ROC曲线评价血清MMP-9、HIF-1α对其疗效的预测价值。术后均随访2年,采用Kaplan-Meier法绘制生存曲线。结果治疗后,HCC患者血清MMP-9、HIF-1α水平低于治疗前(P<0.05),且有效组HCC患者血清MMP-9、HIF-1α水平均低于无效组(P<0.05);ROC分析显示,治疗前血清MMP-9、HIF-1α及联合检测评估TACE疗效的曲线下面积(AUC)分别是0.753、0.763和0.804;生存分析显示,治疗后血清MMP-9低水平患者治疗后2年生存率为69.39%,高于高水平患者(44.00%)(Log Rankχ^(2)=5.761,P<0.05);HIF-1α低水平患者治疗后2年生存率为71.43%,高于高水平患者(40.00%)(Log Rankχ^(2)=8.819,P<0.05)。结论TACE治疗HCC患者的疗效确切,可能通过调节血清MMP-9、HIF-1α水平发挥作用,临床通过检测其治疗前后水平变化,可以评估患者疗效和预后。Objective To explore the relationship between serum matrix metalloproteinase-9(MMP-9),hypoxia-inducible factor 1α(HIF-1α)levels and transcatheter arterial chemoembolization(TACE)treatment efficacy and prognosis in patients with hepatocellular carcinoma(HCC).Methods A total of 74 patients with HCC undergoing TACE were enrolled.According to efficacy criteria of mRECIST,they were divided into effective group(49 cases,shrinkage or stable state of tumors)and ineffective group(25 cases,non-shrinkage or even aggravation of tumors).The levels of serum MMP-9 and HIF-1αwere detected before and after treatment,and their predictive value for curative effect was evaluated by ROC curves.All patients were followed up for 2 years after surgery.The survival curves were drawn by Kaplan-Meier method.Results After treatment,level of serum MMP-9 and level of serum HIF-1αwas decreased in HCC patients(P<0.05).The levels of serum MMP-9 and HIF-1αin effective group were lower than that in ineffective group(P<0.05).ROC curves analysis showed that area under the curve(AUC)values of serum MMP-9,HIF-1αand combined detection for evaluating curative effect of TACE before treatment were 0.753,0.763 and 0.804,respectively.Survival analysis showed that 2-year survival rate in patients with low level of MMP-9 was higher than that with high level(69.39%vs 44.00%,Log Rankχ^(2)=5.761,P<0.05),and which was lower in patients with low level of HIF-1αthan high level(71.43%vs 40.00%,Log Rankχ^(2)=8.819,P<0.05).Conclusion The curative effect of TACE is significant in HCC patients,which may be related to regulating levels of serum MMP-9 and HIF-1α.Clinically,detecting the changes of serum MMP-9 and HIF-1αbefore and after treatment can evaluate curative effect and prognosis of patients.

关 键 词：经肝动脉插管化疗栓塞 肝癌 基质金属蛋白酶-9 低氧诱导因子 预后 

分 类 号：R735.7[医药卫生—肿瘤]