原发性肝癌患者血清HIF-1α、TK1、γ-GT水平与TACE治疗预后的关系  

Relationship between serum levels of HIF-1α,TK1,andγ-GT and the prognosis of TACE treatment in patients with primary liver cancer

作　　者：巩瑞想 曹振振 杨黎冰 徐亚聪 孙荣 刘佳瑶 潘子俊 孟彤 GONG Ruixiang;CAO Zhenzhen;YANG Libing;XU Yacong;SUN Rong;LIU Jiayao;PAN Zijun;MENG Tong(Department of Gastroenterology,the First Affiliated Hospital of Henan University,Kaifeng 475001,Henan,China)

机构地区：[1]河南大学第一附属医院消化科,河南开封475001

出　　处：《右江医学》2024年第8期733-739,共7页Chinese Youjiang Medical Journal

基　　金：2022年开封市科技发展计划(2207011)。

摘　　要：目的探索血清缺氧诱导因子-1α(HIF-1α)、胸苷激酶1(TK1)、γ-谷氨酰转移酶(γ-GT)对原发性肝癌患者经肝动脉导管化疗栓塞术(TACE)治疗预后的预测价值。方法选取2019年10月至2022年10月接受TACE治疗的172例原发性肝癌患者作为癌症组,同期选择156例健康体检者作为对照组。采用酶联免疫吸附法(ELISA)检测血清HIF-1α、TK1水平,采用全自动分析仪检测血清γ-GT水平;分析血清HIF-1α、TK1、γ-GT水平与患者临床病理特征的关系;对原发性肝癌患者TACE治疗后预后不良的影响因素进行单因素及多因素分析;受试者工作特征(ROC)曲线分析血清HIF-1α、TK1、γ-GT检测对原发性肝癌患者TACE治疗后预后不良的预测价值。结果癌症组患者血清HIF-1α、TK1、γ-GT水平高于对照组(P<0.001),患者血清HIF-1α、TK1、γ-GT水平与血管侵犯、肿瘤直径及病灶数目相关(P<0.05或0.001);血清HIF-1α、TK1、γ-GT是患者预后不良的影响因素(P<0.05或0.001);血清HIF-1α、TK1、γ-GT联合预测患者预后不良的ROC曲线下面积(AUC)显著大于HIF-1α单独预测的AUC(Z=2.712,P=0.007),TK1单独预测的AUC(Z=3.642,P<0.001),γ-GT单独预测的AUC(Z=3.347,P<0.001)。结论原发性肝癌患者TACE治疗后血清HIF-1α、TK1、γ-GT水平升高,联合检测其水平对患者预后不良具有较好的预测价值。Objective To explore the predictive value of serum hypoxia inducible factor-1α(HIF-1α),thymidine kinase 1(TK1),andγ-glutamyltransferase(γ-GT)for the prognosis of patients with primary liver cancer undergoing transcatheter arterial chemoembolization(TACE).Methods 172 patients with primary liver cancer who received TACE treatment from October 2019 to October 2022 were selected as cancer group,and 156 healthy individuals who underwent physical examinations during the same period were selected as control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum HIF-1αand TK1 levels,and a fully automatic analyzer was used to detect serumγ-GT level.Relationship between the serum levels of HIF-1α,TK1,andγ-GT and the clinical and pathological characteristics of patients was analyzed.Univariate and multivariate analysis were carried out on the influencing factors of poor prognosis after TACE treatment in patients with primary liver cancer.In addition,receiver operating characteristic(ROC)curve was used to analyze the detection of serum HIF-1α,TK1,andγ-GT for predicting poor prognosis in patients with primary liver cancer after TACE treatment.Results The serum levels of HIF-1α,TK1,andγ-GT in the cancer group were higher than those in the control group(P<0.001),and the serum levels of HIF-1α,TK1,andγ-GT in cancer patients were correlated with vascular invasion,tumor diameter,and lesion number(P<0.05 or 0.001).Serum HIF-1α,TK1,andγ-GT were influencing factors for the poor prognosis of the patients(P<0.05 or 0.001).The ROC area under the curve(AUC)predicted by the combination of serum HIF-1α,TK1,andγ-GT for poor prognosis was significantly larger than that predicted by HIF-1αalone(Z=2.712,P=0.007),TK1 alone(Z=3.642,P<0.001),andγ-GT alone(Z=3.347,P<0.001).Conclusion After TACE treatment,the serum levels of HIF-1α,TK1,andγ-GT in patients with primary liver cancer increase,and combined detection of these levels has good predictive value for poor prognosis in patients.

关 键 词：缺氧诱导因子-1α 胸苷激酶1 γ-谷氨酰转移酶 原发性肝癌 经肝动脉导管化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]