经皮肝动脉化疗栓塞治疗后肝细胞癌患者血管生成素-2基因多态性与预后的相关性

Association between angiopoietin-2 gene polymorphism and prognosis of hepatocellular carcinoma patients after transcatheter arterial chemoembolization treatment

目的探讨经皮肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗后肝细胞癌(hepatocellular carcinoma,HCC)患者血管生成素-2(angiopoietin-2,Ang-2)基因多态性与预后的相关性。方法回顾性分析2013年1月至2015年1月于宝鸡市人民医院行TACE治疗的276例HCC患者的临床资料,所有患者于TACE术前采集血液标本,采用聚合酶链反应-限制性内切酶分析法检测Ang-2基因+1087A/G位点多态性,分析不同Ang-2基因型与患者预后的关系。结果 AA基因型患者1年、2年和3年生存率分别为63.6%、54.2%和50.8%,(AG+GG)基因型患者分别为52.5%、47.5%和36.7%,Log-rank分析结果显示两组生存曲线差异有统计学意义(Log-rank P=0.004)。Cox多因素分析结果显示(AG+GG)基因型、肿瘤数目和TMN分期均为影响TACE术后HCC患者生存时间的独立危险因素,(AG+GG)基因型患者较AA基因型患者病死风险显著增加(OR=1.670,95%CI:1.068～3.136,P=0.007)。结论 Ang-2+1087A/G基因多态性与经TACE治疗的HCC患者预后密切相关。

Objective To investigate the association between angiopoietin-2 （Ang-2） gene polymorphism and prognosis of patients with hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization （TACE） treatment. Methods The clinical data of 276 patients with HCC who underwent TACE treatment in Baoji People’s Hospital from January 2013 to January 2015 were retrospectively analyzed. Blood samples were collected before TACE and the Ang-2 gene ＋1087A/G polymorphism was detected by polymerase chain reaction-restriction enzyme analysis. The correlations between genotypes and prognosis were analyzed. Results The 1-year, 2-year and 3-year survival rates of patients with AA genotype were 63.6%, 54.2% and 50.8%, respectively, which were 52.5%, 47.5% and 36.7% of patients with （AG ＋ GG） genotype, respectively. Log-rank test showed highly significant differences in overall survival between different genotypes （Log- rank P = 0.004）. Cox multivariate analysis showed that genotype AG ＋ GG, tumor number and tumor-node- metastasis （TNM） stage were independently associated with HCC prognosis. The death risk in patients with （AG ＋ GG） genotype was significantly higher than that of AA genotype （OR = 1.670, 95% CI： 1.068～3.136, P = 0.007）. Conclusion Ang-2 gene ＋1087A/G polymorphism is closely related to the prognosis of patients with HCC after TACE treatment.