原发性肝癌患者高强度聚焦超声治疗前后HSP70、PTN、PIVKA-Ⅱ水平变化及对早期复发的预测效能  

Changes in the Levels of HSP70,PTN,and PIVKA-Ⅱbefore and after High-intensity Focused Ultrasound Therapy in Patients with Primary Hepatic Carcinoma and Their Predictive Efficacy for Early Recurrence

作　　者：刘红涛 王冬冬 陈英 LIU Hongtao;WANG Dongdong;CHEN Ying(The Second Department of General Surgery,People's Hospital of Shijiazhuang City,Shijiazhuang 050030,China)

机构地区：[1]石家庄市人民医院普外科二病区,石家庄050030

出　　处：《临床误诊误治》2024年第5期67-72,共6页Clinical Misdiagnosis & Mistherapy

基　　金：石家庄市科学技术研究与发展计划项目(211460893)。

摘　　要：目的探究原发性肝癌(PHC)患者在高强度聚焦超声(HIFU)治疗前后热休克蛋白70(HSP70)、多效生长因子(PTN)、异常凝血酶原Ⅱ(PIVKA-Ⅱ)水平变化及对早期复发的影响和预测效能。方法选取2021年1月—2023年1月收治的PHC 120例,均行HIFU治疗,根据术后6个月是否复发分为复发组(26例)与未复发组(94例)。比较2组临床资料、治疗前后血清HSP70、PTN、PIVKA-Ⅱ水平及变化值(ΔHSP70、ΔPTN、ΔPIVKA-Ⅱ值),分析ΔHSP70、ΔPTN、ΔPIVKA-Ⅱ与HIFU治疗后早期复发的相关性,并评价预测效能。结果2组治疗后血清HSP70、PTN、PIVKA-Ⅱ水平较治疗前下降(P<0.05);复发组治疗前、治疗后血清HSP70、PTN、PIVKA-Ⅱ水平高于未复发组(P<0.01)。复发组血清ΔHSP70、ΔPTN、ΔPIVKA-Ⅱ值低于未复发组(P<0.01)。Spearman相关性分析显示,治疗前血清HSP70、PTN、PIVKA-Ⅱ与肿瘤直径、CNLC分期呈正相关,与分化程度呈负相关(P<0.01)。多因素Logistic回归分析显示,校正肿瘤直径、CNLC分期、分化程度因素前后血清ΔHSP70、ΔPTN、ΔPIVKA-Ⅱ值均与PHC患者HIFU治疗后早期复发独立相关(P<0.01);血清ΔHSP70、ΔPTN、ΔPIVKA-Ⅱ值联合预测PHC患者HIFU治疗后早期复发的曲线下面积为0.916(95%CI:0.851,0.958),敏感度为0.923,特异度为0.872,优于三者单独预测。结论PHC患者HIFU治疗前后HSP70、PTN、PIVKA-Ⅱ水平变化值与早期复发独立相关,且联合预测效能较高。Objective To investigate the changes in the levels of heat shock protein 70(HSP70),pleiotropic growth factor(PTN),and abnormal prothrombinogenⅡ(PIVKA-Ⅱ)in patients with primary hepatic carcinoma(PHC)before and after high-intensity focused ultrasound(HIFU)therapy,as well as their impact on early recurrence and predictive efficacy.Methods A total of 120 patients with PHC treated from January 2021 to January 2023 were selected,followed by HIFU therapy and divided into the recurrence group(n=26)and the non-recurrence group(n=94)according to whether they had recurrence at 6 months after surgery.Clinical data,serum levels of HSP70,PTN,and PIVKA-Ⅱbefore and after treatment,as well as their changes(ΔHSP70,ΔPTN,ΔPIVKA-Ⅱvalues),were compared between the two groups.The correlation betweenΔHSP70,ΔPTN,ΔPIVKA-Ⅱand early recurrence after HIFU therapy was analyzed,and the predictive efficacy was evaluated.Results After treatment,the levels of serum HSP70,PTN,and PIVKA-Ⅱin the two groups decreased compared with those before treatment(P<0.05).The levels of serum HSP70,PTN,and PIVKA-Ⅱin the recurrence group before and after treatment were higher than those in the non-recurrence group(P<0.01).TheΔHSP70,ΔPTN,andΔPIVKA-Ⅱvalues in the recurrence group were lower than those in the non-recurrence group(P<0.01).Spearman correlation analysis showed that before treatment,serum HSP70,PTN,and PIVKA-Ⅱwere positively correlated with tumor diameter and CNLC stage,and negatively correlated with differentiation degree(P<0.01).Multivariate Logistic regression analysis showed that before and after adjusting for tumor diameter,CNLC stage,and differentiation degree factors,both serumΔHSP70,ΔPTN,andΔPIVKA-Ⅱlevels were independently associated with early recurrence of PHC patients after HIFU therapy(P<0.01).The area under the receiver operating characteristic(ROC)curve(AUC)of serumΔHSP70,ΔPTN,andΔPIVKA-Ⅱvalues for predicting early recurrence of PHC patients after HIFU therapy was 0.916(95%CI:0.851,0.958),with a sensi

关 键 词：肝肿瘤 高强度聚焦超声 热休克蛋白70 多效生长因子 异常凝血酶原Ⅱ 早期复发 相关性 预测效能 

分 类 号：R735.7[医药卫生—肿瘤]