血清STIP1、sPD-L1水平与肝癌TACE术后患者预后的关系

The relationship between serum STIP1 and sPD-L1 levels and prognosis of patients with liver cancer after TACE

目的探讨血清磷酸化应激诱导蛋白1(STIP1)、可溶性程序性死亡配体1(sPD-L1)在肝癌经肝动脉化疗栓塞(TACE)治疗后患者预后中的评估价值。方法选取2015年1月至2017年6月在该院接受TACE治疗的肝癌患者126例为肝癌组,另选同期在该院进行健康体检的体检健康者80例为对照组。采用酶联免疫吸附法检测两组患者血清STIP1、sPD-L1水平。采用受试者工作特征(ROC)曲线分析血清STIP1、sPD-L1在肝癌TACE术后患者预后中的评估价值。采用单因素和多因素Cox比例风险回归分析影响肝癌患者不良预后的危险因素。结果肝癌组患者血清STIP1、sPD-L1水平均高于对照组,肝癌治疗后血清STIP1、sPD-L1水平低于治疗前,差异均有统计学意义(P<0.05)。ROC曲线表示:血清STIP1、sPD-L1及联合检测预测肝癌TACE术后患者预后的AUC分别为0.818、0.861、0.939。根据血清STIP1、sPD-L1最佳cut off值,将患者分为高低STIP1、sPD-L1组。高STIP1、sPD-L1组患者的生存率分别低于低STIP1、sPD-L1组,差异有统计学意义(P<0.05)。Cox比例风险多因素回归分析表示:肿瘤数量、肿瘤直径、门静脉癌栓、血清STIP1和sPD-L1是影响肝癌TACE术后患者预后不良的独立危险因素(P<0.05)。结论血清STIP1、sPD-L1水平变化与肝癌TACE术后患者的预后有关,两项联合检测可用于评估肝癌TACE术后患者预后。

Objective To explore the evaluation value of serum stress-induced phosphoprotein 1(STIP1)and soluble programmed death ligand 1(sPD-L1)in the prognosis of patients with liver cancer after transhepatic artery chemoembolization(TACE)treatment.Methods From January 2015 to June 2017,126 patients with liver cancer who received TACE treatment in our hospital were selected as the liver cancer group,and 80 healthy people who received physical examination in our hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the levels of serum STIP1 and sPD-L1 in the two groups.The receiver operating characteristic(ROC)curve was used to analyze the evaluation value of serum STIP1 and sPD-L1 in the prognosis of patients with liver cancer after TACE.Univariate and multivariate Cox proportional hazards regression analysis were used to analyze the risk factors that affect the poor prognosis of patients with liver cancer.Results The levels of serum STIP1 and sPD-L1 in the liver cancer group were higher than those in the control group.The levels of serum STIP1 and sPD-L1 after liver cancer treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).The ROC curve showed that the AUC of serum STIP1,sPD-L1 and combined detection to predict the prognosis of liver cancer patients after TACE were 0.818,0.861,0.939,respectively.According to the best cut off value of serum STIP1 and sPD-L1,the patients were divded into high and low STIP1 and sPD-L1 groups.The survival rates of patients in the high STIP1 and sPD-L1 groups were lower than those in the low STIP1 and sPD-L1 groups,respectively,and the difference was statistically significant(P<0.05).Cox proportional hazard multivariate regression analysis showed that tumor number,tumor diameter,portal vein tumor thrombus,serum STIP1 and sPD-L1 were independent risk factors affecting the poor prognosis of patients with liver cancer after TACE,and the differences were statistically significant(P<0.05).Conclusion The changes of serum STIP1 and sPD-L1 levels are related to the prognosis of patients with liver cancer after TACE.The two combined tests can be used as auxiliary indicators to evaluate the prognosis of patients with liver cancer after TACE.