外周血清中低氧诱导因子-1α和AFP-L3差异化表达评估TACE联合RFA治疗原发性肝癌预后的相关研究  

Differential expression of HIF-1αand AFP-L3 in peripheral serum to evaluate the prognosis of TACE combined with RFA in the treatment of primary liver cancer

作　　者：张济世 刘磊[1] 石鑫林 ZHANG Jishi;LIU Lei;SHI Xinlin(Department of General Surgery,Qingdao Huangdao District People′s Hospital,Qingdao,Shandong 266000,China)

机构地区：[1]青岛市黄岛区人民医院普通外科,山东青岛266000

出　　处：《国际检验医学杂志》2023年第S02期158-163,共6页International Journal of Laboratory Medicine

摘　　要：目的探究外周血清中低氧诱导因子-1α(HIF-1α)和甲胎蛋白异质体(AFP-L3)差异化表达在TACE联合RFA治疗原发性肝癌(HCC)预后的相关性研究。方法本研究为回顾性病例对照研究,收集自2020年1月至2022年1月该院普通外科收治的186例中晚期原发性肝癌患者为研究对象,所有患者均采用肝动脉化疗栓塞术(TACE)联合射频消融术(RFA)治疗方案,根据术后恢复情况进行分组,分成预后良好组109例和预后不良组77例。收集患者的一般资料,临床病理学资料,包括肿瘤最大径,直径和Child分级。利用全自动生化分析仪测定丙氨酸氨基转移酶,天门冬氨酸氨基转移酶含量;利用ELISA试剂盒检测HIF-1α和AFP-L3含量,生存率的计算采用Kaplan-Meier法,单因素分析和多因素分析均采用COX比例风险回归模型。结果所有入组186例HCC患者经过TACE联合RFA治疗后随访时间为12个月,预后良好患者109例,预后不良患者77例。预后不良组患者的体重指数(BMI)偏小,家庭收入较低,HIF-1α和AFP-L3含量高,比较差异具有统计学意义(P<0.05),单因素和多因素分析结果显示,HIF-1α和AFP-L3含量与患者预后密切相关(P<0.05),受试者工作特征(ROC)曲线结果显示,HIF-1α联合AFP-L3预测曲线下面积(AUC)为0.915。HIF-1α的Cut-off值为412.56 pg/mL,AFP-L3的Cut-off值为527.27 ng/mL,Kaplan-Meier生存曲线结果显示,HIF-1α和AFP-L3升高组患者的OS%和PFS%均低于HIF-1α和AFP-L3降低组患者(P<0.05)。结论HIF-1α和AFP-L3与原发性肝癌患者选择TACE联合RFA治疗的预后密切相关,可以作为生物标志物反映预后效果。Objective To explore the correlation between differential expression of hypoxia-inducible factor-1α(HIF-1α)and alpha-fetoprotein isoform L3(AFP-L3)in peripheral serum and prognosis of primary liver cancer treated with transcatheter arterial chemoembolization(TACE)combined with radiofrequency ablation(RFA).Methods This study was a retrospective case-control study.A total of 186 patients with advanced primary liver cancer admitted to Huangdao District People′s Hospital from January 2020 to January 2022 were included as the research objects.All patients received TACE combined with RFA treatment,and were divided into good prognosis group and poor prognosis group according to postoperative recovery.The general baseline data and clinical pathological data of the patients were collected,including tumor size,diameter,and Child-Pugh classification.The levels of alanine aminotransferase and aspartate aminotransferase were measured by an automatic biochemical analyzer;the levels of HIF-1αand AFP-L3 were detected by ELISA kit.The survival rate was calculated using the Kaplan-Meier method,and Cox proportional hazards regression model was used for univariate and multivariate analysis.Results After TACE combined with RFA treatment,all 186 HCC patients were followed up for 12 months,with 109 patients in the good prognosis group and 77 patients in the poor prognosis group.The poor prognosis group had lower BMI,lower household income,higher levels of HIF-1αand AFP-L3,and significant statistical differences(P<0.05).Univariate and multivariate analysis results showed that the levels of HIF-1αand AFP-L3 were closely related to patient prognosis(P<0.05).The ROC curve results showed that the combined prediction of HIF-1αand AFP-L3 had an AUC of 0.915.The Cut-off value of HIF-1αwas 412.56 pg/mL,and the Cut-off value of AFP-L3 was 527.27 ng/mL.Kaplan-Meier survival curve results showed that the OS%and PFS%of patients with elevated levels of HIF-1αand AFP-L3 were lower than those with decreased levels of HIF-1αand AFP-L3(P<0.05

关 键 词：原发性肝癌 肝动脉化疗栓塞术 射频消融术 低氧诱导因子-1Α 甲胎蛋白异质体 

分 类 号：R735.7[医药卫生—肿瘤]