FasL、Caspase-9表达水平对肝细胞性肝癌患者介入治疗后预后的判断价值分析  

Analysis of the Prognostic Value of FasL and Caspase-9 Expression Levels in Patients with Hepatocellular Carcinoma After Interventional Therapy

作　　者：许冉[1] 常永闯 杜晓阳 曹语嫣 岳宁双 XU Ran;CHANG Yongchuang;DU Xiaoyang(Anyang People's Hospital,Anyang,455000)

机构地区：[1]河南省安阳市人民医院,455000

出　　处：《实用癌症杂志》2024年第7期1079-1083,共5页The Practical Journal of Cancer

摘　　要：目的 探讨介入治疗前后肝细胞性肝癌(HCC)患者Fas配体(FasL)、半胱氨酸天冬氨酸蛋白酶-9(Caspase-9)表达变化及意义。方法 选取68例接受介入治疗的HCC患者为研究对象。对比治疗前后HCC患者FasL、Caspase-9水平。统计HCC患者复发情况,并分为复发组和未复发组。对比复发组和未复发组临床资料、治疗前后FasL、Caspase-9水平。Logistic多因素回归分析影响HCC患者治疗后复发的危险因素。制作受试者工作特征曲线(ROC),以曲线下面积(AUC)评价FasL、Caspase-9对HCC患者治疗后复发的预测价值。结果 与治疗前相比,治疗后患者FasL水平降低(P<0.05),Caspase-9水平升高(P<0.05)。随访结束,介入治疗的HCC患者复发发生率为47.06%(32/68)。复发组肿瘤最大直径、肿瘤个数、治疗后FasL水平高于未复发组(P<0.05),治疗后Caspase-9水平低于未复发组(P<0.05)。多因素分析结果显示:肿瘤最大直径(OR=2.619,95%CI:1.126~6.092)、治疗后FasL(OR=2.134,95%CI:1.264~3.602)、治疗后Caspase-9(OR=0.975,95%CI:0.954~0.997)是HCC患者治疗后复发的相关因素(P<0.05)。ROC分析显示,治疗后FasL、Caspase-9及两者联合检测对预测HCC患者治疗后复发灵敏度分别为78.12%(95%CI:59.56%~90.06%)、71.87%(95%CI:53.02%~85.60%)、93.75%(95%CI:77.78%~98.91%),特异度分别为72.22%(95%CI:54.57%~85.21%)、80.56%(95%CI:63.43%~91.20%)、72.22%(95%CI:54.57%~85.21%),AUC分别为0.794(95%CI:0.679~0.883)、0.785(95%CI:0.668~0.875)、0.867(95%CI:0.763~0.937)。结论 介入治疗后HCC患者FasL水平降低、Caspase-9水平升高。治疗后FasL、Caspase-9可作为临床评估HCC患者治疗后复发的重要参考指标。Objective To investigate the changes and significance of FasL and Caspase-9 expression in patients with hepatocellular carcinoma(HCC)before and after interventional therapy.Methods A total of 68 patients with HCC who received interventional treatment were selected as the study subjects.The levels of FasL and Caspase-9 in HCC patients before and after treatment were compared.The recurrence rate of HCC patients was statistically analyzed and divided into recurrent group and non recurrent group.The clinical data,levels of FasL and Caspase-9 before and after treatment were compared between the recurrent group and the non recurrent group.Logistic multivariate regression analysis was used to analyze the risk factors for after treatment recurrence in patients with HCC.Subjects'working characteristic curve(ROC)was prepared to evaluate the predictive value of FasL and Caspase-9 for after treatment recurrence in HCC patients using area under curve(AUC).Results Compared with pre treatment,the level of FasL in patients after treatment decreased(P<0.05),while the level of Caspase-9 increased(P<0.05).By the end of follow-up,the recurrence rate of HCC patients undergoing interventional therapy was 47.06%(32/68).The maximum tumor diameter,number of tumors,and FasL level after treatment in the recurrent group were higher than those in the non recurrent group(P<0.05),while the Caspase-9 level after treatment was lower than that in the non recurrent group(P<0.05).Multivariate analysis showed that the maximum tumor diameter(OR=2.619,95%CI:1.126~6.092),FasL after treatment(OR=2.134,95%CI:1.264~3.602),and Caspase-9 after treatment(OR=0.975,95%CI:0.954~9.997)were related factors affecting after treatment recurrence in HCC patients(P<0.05).ROC analysis showed that the sensitivity of FasL,Caspase-9 and their combined detection to predict the recurrence of HCC patients after treatment were 78.12%(95%CI:59.56%~90.06%),[LM]71.87%(95%CI:53.02%~85.60%),93.75%(95%CI:77.78%~98.91%),the specificity were 72.22%(95%CI:54.57%~85.21%),80.56%(95%CI:6

关 键 词：肝细胞性肝癌 经导管动脉化疗栓塞 介入治疗 FAS配体 半胱氨酸天冬氨酸蛋白酶-9 复发 

分 类 号：R735.7[医药卫生—肿瘤]