上皮间质转化相关基因水平评估肝癌免疫治疗疗效的应用价值  

Application value of epithelial-mesenchymal transition-related gene levels in evaluating the efficacy of liver cancer immunotherapy

作　　者：韩雪[1] 李帅 徐蓉[2] 马文静 黄国虹[1] HAN Xue;LI Shuai;XU Rong;MA Wenjing;HUANG Guohong(Department of Clinical Laboratory,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China;Department of Oncology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China;Department of Clinical Laboratory,Urumqi Hospital of Traditional Chinese Medicine,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆维吾尔自治区人民医院检验科,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院肿瘤科,新疆乌鲁木齐830001 [3]新疆维吾尔自治区乌鲁木齐市中医医院检验科,新疆乌鲁木齐830002

出　　处：《国际检验医学杂志》2023年第23期2914-2918,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2019D01C117)。

摘　　要：目的分析上皮间质转化(EMT)相关基因水平评估肝癌免疫治疗效果的应用价值。方法将2020年1月至2021年1月于新疆维吾尔自治区人民医院行免疫治疗的113例肝癌患者纳入研究,根据患者预后将其分为预后良好组75例和预后不良组32例。采用酶联免疫吸附试验检测EMT相关基因[Snail、Twist、E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)]水平;采用多因素Cox回归分析肝癌免疫治疗效果不佳的影响因素;采用受试者工作特征(ROC)曲线评估EMT相关基因对患者免疫治疗疗效的诊断价值;建立患者免疫治疗疗效的列线图模型,并对列线图模型进行内部验证,并用一致性指数(C-index)量化模型预测性能。结果预后良好组患者的Snail、Twist及N-cadherin水平低于预后不良组(均P<0.05),E-cadherin水平高于预后不良组(P=0.001)。多因素Cox回归结果显示,Snail、Twist及N-cadherin水平是患者免疫治疗效果不佳的独立危险因素,E-cadherin水平则是独立保护因素。列线图模型预测患者免疫治疗预后相关C-index为0.923(95%CI 0.876~0.943)。ROC曲线结果显示,Snail、Twist、E-cadherin、N-cadherin 4项指标联合预测患者免疫治疗效果不佳的预测效能优于各项指标单独预测(均P<0.05)。结论EMT相关基因水平能有效预测患者免疫治疗预后,有助于早期肝癌患者采取有效干预措施进行治疗。Objective To analyze the application value of epithelial-mesenchymal transition(EMT)-related genes in evaluating the efficacy of immunotherapy for liver cancer.Methods A total of 113 patients with liver cancer who received immunotherapy in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to January 2021 were included in the study.According to the prognosis of the patients,they were divided into the good prognosis group(75 cases)and the poor prognosis group(32 cases).EMT-related genes(Snail,Twist,E-cadherin,N-cadherin)were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate Cox regression analysis was used to analyze the influencing factors of poor efficacy of immunotherapy for liver cancer.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of EMT-related genes for the efficacy of immunotherapy.A nomogram model was established to predict the efficacy of immunotherapy in patients,and the nomogram model was internally validated.The predictive performance of the model was quantified by the consistency index(C-index).Results The levels of Snail,Twist and N-cadherin in the good prognosis group were lower than those in the poor prognosis group(all P<0.05),and the level of E-cadherin was higher than that in the poor prognosis group(P=0.001).Multivariate Cox regression analysis showed that the levels of Snail,Twist and N-cadherin were independent risk factors for poor efficacy of immunotherapy in patients,and the level of E-cadherin was an independent protective factor.The C-index of nomogram model predicting the prognosis of immunotherapy was 0.923(95%CI 0.876-0.943).The results of ROC curve showed that the combination of Snail,Twist,E-cadherin and N-cadherin had a better predictive value than each index alone in predicting the poor efficacy of immunotherapy(all P<0.05).Conclusion The levels of EMT-related genes can effectively predict the prognosis of patients with immunotherapy,which is helpful for early liver cancer patients to take effect

关 键 词：上皮间质转化 基因表达 肝癌 免疫治疗 

分 类 号：R735.7[医药卫生—肿瘤]