肝细胞癌根治性切除术后复发转移与血清转化生长因子-β1的关系

Serum TGF-β1 is a potential predictor for metastasis and recurrence after radical resection of hepatocellular carcinoma

目的 探讨肝细胞癌 (HCC)患者术前血清转化生长因子 β1(TGF β1)与HCC根治性切除术后复发转移的关系。方法 应用酶联免疫吸附分析方法 (ELISA)检测 5 1例HCC患者术前血清TGF β1水平。采用Cox比例风险模型 ,对影响预后的指标进行分析 ,确定影响术后复发转移的指标。结果 HCC患者根治性切除术后 2年有复发转移组术前血清TGF β1水平(3 65 .13±10 8.67)ng/L明显高于无复发转移组(2 41.0 6± 89.73 )ng/L(P <0 .0 1)、术前血清TGF β1水平有癌栓组 (3 73 .13± 119.40 )ng/L明显高于无癌栓组(2 5 4.18± 81.5 6)ng/L(P <0 .0 1)、大肝癌组(3 5 1.44± 93 .79)ng/L明显高于小肝癌组 (2 76.83± 10 1.90 )ng/L (P <0 .0 1)、肿瘤无包膜组(3 42 .2 0± 13 0 .5 6)ng/L明显高于有包膜组(2 3 7.42± 97.89)ng/L(P <0 .0 5 )。Cox比例风险模型显示 :血清TGF β1、门静脉癌栓及肿瘤大小是影响HCC切除术后患者复发转移时间的显著因素(P值分别为 0 .0 0 5、0 .0 12和 0 .0 45 )。结论 HCC患者术前血清TGF β1水平是预测HCC根治性切除术后复发转移的指标。

Objective To study the significance of serum transforming growth factor β1 (TGF β1) as a predictor for metastasis and recurrence after radical resection of hepatocellular carcinoma (HCC).Methods Enzyme linked immunosorbent assay (ELISA) was used to determineserum levels of TGF β1 in 51 HCC patients.Cox,s proportional hazard model was used to analyze significant clinical factors related to the prognosis.Results Serum TGF β1 level in recurrence group (365.13± 108.67) ng/L was higher than that in the group without recurrence (241.06± 89.73) ng/L ( P < 0.01). Serum TGF β1 level in patients with tumor thrombosis (373.13± 119.40) ng/L was higher than that in the group without thrombosis (254.18± 81.56) ng/L ( P < 0.01). Serum TGF β1 level in large tumor group (351.44± 93.79) ng/L was higher than that in small cancer group (276.83± 101.90) ng/L ( P < 0.01). Serum TGF β1 level in group without capsule (342.20± 130.56) ng/L was higher than that in group with capsule (237.42± 97.89) ng/L ( P < 0.05). Cox,s proportional hazard model showed that serum TGF β1 level,tumor thrombosis in the portal vein and tumor size were related positively to recurrence and metastasis of HCC patients after radical resection ( P = 0.005, P = 0.012 and P = 0.045, respectively).Conclusion Serum TGF β1 level is a predictor for metastasis and recurrence after radical resection of HCC.