术前血清VEGF和IL-12水平对原发性肝癌腹腔镜肝切除术预后的影响  

Influence of preoperative serum VEGF and IL-12 levels on the prognosis of primary liver cancer after laparoscopic hepatectomy

作　　者：丁兢[1] 邸亮[1] 李聪[1] 赵晓飞[1] 郭庆良[1] 马超[1] DING Jing;DI Liang;LI Cong;ZHAO Xiaofei;GUO Qingliang;MA Chao(Center of General Surgery,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院普通外科中心,北京100069

出　　处：《肝胆胰外科杂志》2023年第8期459-463,共5页Journal of Hepatopancreatobiliary Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2021-17-8)。

摘　　要：目的分析原发性肝癌患者血清血管内皮生长因子(VEGF)、白细胞介素12(IL-12)水平对腹腔镜肝切除术预后的影响。方法回顾性收集2020年1月至2022年6月在首都医科大学附属北京佑安医院接受腹腔镜肝切除术治疗的原发性肝癌患者的临床资料,根据其预后结局分为预后不良组(80例)与预后良好组(80例)。所有患者一般资料、实验室检查资料均完整。分析术前血清VEGF、IL-12水平对原发性肝癌腹腔镜肝切除术治疗预后的影响。结果预后不良组与预后良好组间血清VEGF、IL-12、甲胎蛋白(AFP)水平比较差异均有统计学意义(P<0.05);Logistic回归分析发现,腹腔镜肝切除术前患者高水平血清VEGF、AFP可能是术后预后不良的风险因子(OR>1,P<0.05),而术前高水平血清IL-12可能是其保护因子(OR<1,P<0.05);受试者工作特征曲线(ROC)显示,原发性肝癌患者接受腹腔镜肝切除术治疗前血清VEGF、IL-12水平预测手术预后的曲线下面积(AUC)均>0.80,血清VEGF和IL-12联合预测的AUC为0.842。结论原发性肝癌患者术前血清VEGF、IL-12水平单独或联合均可以较好地预测腹腔镜肝切除术预后,高水平的VEGF以及低水平的IL-12均提示较差的预后。Objective To analyze the influence of serum vascular endothelial growth factor(VEGF)and interleukin-12(IL-12)levels on the prognosis of patients with primary liver cancer undergoing laparoscopic hepatectomy.Methods The clinical data of patients with primary liver cancer,who received laparoscopic hepatectomy in Beijing You’an Hospital from Jan.2020 to Jun.2022,were retrospectively collected.According to prognosis,patients were divided into poor prognosis group(80 cases)and good prognosis group(80 cases),the general information and laboratory examination data were all complete.The influence of preoperative serum VEGF and IL-12 levels on the patients prognosis after laparoscopic hepatectomy was analyzed.Results There were statistical significant differences in serum VEGF,IL-12,and alpha fetoprotein(AFP)levels between the poor prognosis group and the good prognosis group(P<0.05).Logistic regression analysis showed that the high level of serum VEGF and AFP before laparoscopic hepatectomy might be the risk factors for poor prognosis after surgery(OR>1,P<0.05),while the high level of serum IL-12 before surgery might be the protective factors(OR<1,P<0.05).The receiver operator characteristic curve(ROC)showed that the areas under the curve(AUC)predicted by both serum VEGF and IL-12 levels before laparoscopic hepatectomy were all>0.80,and the AUC predicted by combined serum VEGF and IL-12 was 0.842.Conclusion Preoperative serum VEGF and IL-12 levels in patients with primary liver cancer,alone or jointly,can predict the prognosis after laparoscopic hepatectomy.Either high levels of VEGF or low levels of IL-12 indicates poor prognosis.

关 键 词：原发性肝癌 腹腔镜肝切除术 血管内皮生长因子(VEGF) 白细胞介素12(IL-12) 预后 

分 类 号：R735.7[医药卫生—肿瘤]