血清铁蛋白与原发性肝癌预后的相关性分析

Correlation between serum ferritin and clinical prognosis of patients with primary liver cancer

目的探讨血清铁蛋白(SF)与原发性肝癌(肝癌)预后的关系。方法回顾性分析2011年1月至2013年1月在中山大学附属第三医院收治的380例肝癌患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男339例女41例;年龄21~86岁,中位年龄54岁。根据参考值范围将患者分为SF正常组及SF升高组。随访患者的生存情况。生存分析采用Kaplan-Meier法和Log-rank检验。SF水平与肝癌患者预后的相关性分析采用Cox比例风险回归模型。结果患者1、2、3年生存率分别为62.9%、45.3%、16.8%。多因素Cox回归分析显示,SF、TNM分期、治疗方法为肝癌患者预后的独立危险因素(OR=1.771,3.695,0.224;P<0.05)。生存分析显示,SF升高组患者总体生存明显差于SF正常组(χ^(2)=11.530,P<0.05)。亚组分析显示,TACE治疗患者中SF升高患者总体生存亦明显差于SF正常患者(χ^(2)=10.120,P<0.05)。结论SF的表达水平与肝癌预后相关,SF升高预示着患者更短的生存时间。

Objective To investigate the correlation between the serum ferritin(SF)and clinical prognosis of patients with primary liver cancer(PLC).Methods Clinical data of 380 patients with PLC admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to January 2013 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,339 patients were male and 41 female,aged from 21 to 86 years with a median age of 54 years.According to the SF reference value,all patients were divided into the normal SF and high SF groups.The survival of patients was followed up.Survival analysis was performed by Kaplan-Meier method and Log-rank test.The correlation between SF level and clinical prognosis of PLC patients was analyzed by Cox's proportional hazard regression model.Results The 1-,2-and 3-year survival rates were 62.9%,45.3%,and 16.8%,respectively.Cox's regression analysis showed that SF,TNM staging and treatment were the independent risk factors for the clinical prognosis of PLC patients(OR=1.771,3.695,0.224;P<0.05).Survival analysis showed that the overall survival of PLC patients with elevated SF was significantly worse than those with normal SF(χ^(2)=11.530,P<0.05).For the patients receiving TACE,subgroup analysis result revealed that the overall survival of patients with elevated SF was significantly worse than those with normal SF(χ^(2)=10.120,P<0.05).Conclusions The expression level of SF is associated with the clinical prognosis of PLC patients.Elevated SF levels indicates shorter survival time.