血清KLF5和actinin-4水平与肝细胞肝癌肝动脉化疗栓塞术治疗预后的关系  

Association of serum KLF5 and actinin-4 levels with prognosis of TACE treatment for hepatocellular carcinoma

作　　者：李顺乐[1] 李蓉[2] 田亚亚 冉小丽 赵延培 徐蒙 LI Shunle;LI Rong;TIAN Yaya;RAN Xiaoli;ZHAO Yanpei;XU Meng(Department of General Surgery,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China;Department of Anesthesiology,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院普通外科,陕西西安710004 [2]西安交通大学第二附属医院麻醉科,陕西西安710004

出　　处：《基础医学与临床》2024年第9期1284-1289,共6页Basic and Clinical Medicine

基　　金：陕西省2021年重点研发计划(2021SF-229);西安市科技局创新能力支撑计划-医学研究项目(23YXYJ0172);陕西省重点研发计划(2023-YBSF-386)。

摘　　要：目的探讨血清Krüpple样因子5(KLF5)、辅肌动蛋白4(actinin-4)对肝细胞肝癌(HCC)肝动脉化疗栓塞术(TACE)治疗预后的关系。方法选取西安交通大学第二附属医院2015年3月至2020年3月期间收治的130例HCC患者作为HCC组,同期收治的86例肝硬化患者作为对照。术后随访3年,根据生存结局分为生存组(n=38)和死亡组(n=92)。采用ELISA检测各组血清KLF5和actinin-4水平,并分析血清KLF5与actinin-4水平之间的相关性;Cox回归分析HCC患者预后死亡的影响因素;受试者工作特征曲线(ROC)评估血清KLF5和actinin-4水平对HCC患者预后死亡的预测价值。结果死亡组患者血清KLF5和actinin-4水平明显高于生存组(P<0.05),且血清KLF5与actinin-4水平呈正相关(P<0.001);低分化、中国肝癌分期方案(CNLC)分期为Ⅲa期、血管侵犯、KLF5和actinin-4水平升高是HCC患者预后死亡的危险因素(P<0.05);血清KLF5和actinin-4单独及联合预测HCC患者预后死亡的曲线下面积(AUC)分别为0.835、0.866、0.936,联合预测效果较高(Z二者联合-KLF5=2.792,P=0.005,Z二者联合-actinin-4=2.014,P=0.044)。结论HCC患者血清KLF5和actinin-4水平升高,二者血清水平对预后具有较高预测价值。Objective To explore the relationship between serum Krüppel-like factor 5(KLF5)and actinin-4 with prognosis of hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE).Methods From March 2015 to March 2020,130 HCC patients admitted into the Second Affiliated Hospital were collected as study subjects and divided into HCC group and 86 patients with liver cirrhosis were collected as control group.After 3 years of postoperative follow-up,HCC patients were sub-divided into survival group(n=38)and mortality group(n=92)based on their survival outcomes.ELISA was applied to detect the level of serum KLF5 and actinin-4 in each group and analyzed the correlation between serum KLF5 and actinin-4 levels.Cox regression was applied to analyze the risk factors affecting the prognostic mortality of HCC patients;Receiver operating characteristic curve(ROC)was plotted to evaluate the predictive value of serum KLF5 and actinin-4 levels for the prognostic mortality of HCC patients.Results The serum level of KLF5 and actinin-4 in the mortality group was significantly higher than those in the survival group(P<0.05);There was a positive correlation between serum level of KLF5 and actinin-4 in HCC patients(P<0.001);Low differentiation,staging(CNLC)stage IIIa of China liver cancer staging(CNLC),vascular invasion and elevated level of KLF5 and actinin-4 were risk factors for prognostic mortality in HCC patients(P<0.05);The area under the curve(AUC)of serum KLF5 and actinin-4 alone and in combination for predicting mortality in HCC patients was 0.835,0.866,and 0.936,respectively,showing a high level of combined predicting function(Zcombination-KLF5=2.792,P=0.005,Zcombination-actinin-4=2.014,P=0.044).Conclusions Serum level of KLF5 and actinin-4 l found in HCC patients has a high predictive value for prognosis.

关 键 词：Krüpple样因子5 辅肌动蛋白4 肝细胞肝癌 预后 

分 类 号：R735.7[医药卫生—肿瘤]