乙肝相关肝癌患者血清中癌基因C-myc、N-ras、PLK1、FGF2蛋白水平对TACE术后预后的预测价值分析  

Analysis of the predictive value of the protein level of oncogenes C-myc,N-ras,PLK 1,and FGF2 in the serum of hepatitis B-related liver cancer patients on the prognosis after TACE

作　　者：周阳 尹星[1] 付民 常欢 邢艳丽[1] 李毅星[1] 尹先哲[1] ZHOU Yang;YIN Xing;FU Min;CHANG Huan;XING Yanli;LI Yixing;YIN Xianzhe(Department of Oncology,the Second People′s Hospital of Nanyang,Nanyang,Henan 473000,China)

机构地区：[1]河南省南阳市第二人民医院肿瘤科,河南南阳473000

出　　处：《国际检验医学杂志》2024年第3期347-352,357,共7页International Journal of Laboratory Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020992)。

摘　　要：目的探讨乙型肝炎(简称乙肝)相关肝癌患者血清中癌基因[增殖相关基因(C-myc)、转化基因(N-ras)、丝/苏氨酸激酶1(PLK1)、成纤维细胞生长因子2(FGF2)]蛋白水平对肝动脉化疗栓塞术(TACE)后预后的预测价值。方法选取该院于2016年7月至2021年1月收治的乙肝相关肝癌患者127例,根据随访结果将患者分为死亡组和存活组。采用双抗体夹心酶联免疫吸附法测定患者术前血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平,单因素及多因素Cox分析血清中癌基因C-myc、N-ras、PLK1、FGF2蛋白水平与乙肝相关肝癌患者TACE术后预后的危险因素;通过受试者工作特征曲线来评估血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平对乙肝相关肝癌患者预后的预测价值,并根据对应的截断值将乙肝相关肝癌患者分为血清中癌基因C-myc、N-ras、PLK1、FGF2蛋白水平高表达组与低表达组,采用Kaplan-Meier生存曲线评估不同血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平的预后生存情况。结果多因素Cox回归分析结果提示,TNM分期Ⅲ~Ⅳ期(HR=2.998,95%CI:1.239~7.257)、有门静脉转移(HR=3.737,95%CI:1.941~7.193)、有腹腔转移(HR=3.482,95%CI:1.709~7.097)、Child-Pugh分级B级(HR=2.587,95%CI:1.045~6.406)、高血清癌基因C-myc蛋白水平(HR=1.224,95%CI:1.090~1.374)、高血清癌基因N-ras蛋白水平(HR=1.218,95%CI:1.097~1.353)、高血清癌基因PLK1蛋白水平(HR=1.237,95%CI:1.110~1.379)、高血清癌基因FGF2蛋白水平(HR=1.141,95%CI:1.060~1.228)均是影响乙肝相关肝癌患者TACE术后预后的独立危险因素(均P<0.05)。血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平低表达组的总生存率均明显高于血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平高表达组,差异有统计学意义(均P<0.001)。结论血清癌基因C-myc、N-ras、PLK1、FGF2蛋白水平对乙肝相关肝癌患者TACE术后预后具有预测价值。Objective To investigate the predictive value of serum oncogene[proliferation-related gene(C-myc),transformation gene(N-ras),silk/threonine kinase 1(PLK1),fibroblast growth factor 2(FGF2)]protein levels in patients with hepatitis B associated hepatocellular carcinoma(HCC)after hepatic arterial chemoembolization(TACE).Methods A total of 127 patients with hepatitis B-associated hepatocellular carcinoma admitted to a hospital from July 2016 to January 2021 were selected and divided into death group and survival group according to the follow-up results.The serum oncogene C-myc,N-ras,PLK1 and FGF2 protein levels were determined by double-antibody sandwich enzyme-linked immunosorbent assay.Univariate and multivariate Cox analysis were used to analyze the risk factors of serum oncogene C-myc,N-ras,PLK1 and FGF2 protein levels in patients with hepatitis B-associated hepatocellular carcinoma after TACE.The receiver operating characteristic curve was used to evaluate the prognostic value of the serum oncogene C-myc,N-ras,PLK1 and FGF2 protein levels,and the patients were divided into high expression group and low expression group according to the corresponding cutoff value.Kaplan-Meier survival curve was used to evaluate the prognosis of different serum oncogene C-myc,N-ras,PLK1 and FGF2 protein level.Results Multivariate Cox regression analysis indicated that TNM stageⅢtoⅣ(HR=2.998,95%CI:1.239—7.257),portal vein metastasis(HR=3.737,95%CI:1.941—7.193),abdominal metastasis(HR=3.482,95%CI:1.709—7.097),Child-Pugh grade B(HR=2.587,95%CI:1.045—6.406),high serum oncogene C-myc protein level(HR=1.224,95%CI:1.090—1.374),high serum oncogene N-ras protein level(HR=1.218,95%CI:1.097—1.353),high serum oncogene PLK1 protein level(HR=1.237,95%CI:1.110—1.379)and high serum oncogene FGF2 protein level(HR=1.141,95%CI:1.060—1.228)were independent risk factors for the prognosis of hepatitis B-associated hepatocellular carcinoma patients after TACE(all P<0.05).The overall survival rate of low expression group of serum onco

关 键 词：乙肝相关肝癌 血清癌基因 肝动脉化疗栓塞术 预后 

分 类 号：R735.7[医药卫生—肿瘤]