血清肌肉生长抑素、多配体蛋白聚糖-1对酒精性肝硬化患者肝癌发生风险及其预后评估价值

Evaluation value of serum myostatin and syndecan-1 on the risk and prognosis of liver cancer in patients with alcoholic liver cirrhosis

目的探讨血清肌肉生长抑素、多配体蛋白聚糖-1对酒精性肝硬化患者肝癌发生风险及其预后的评估价值。方法选取自2015年1月至2017年12月收治的159例酒精性肝硬化患者为研究对象。根据患者肝癌发生情况分为肝癌组(n=68)与非肝癌组(n=91)。另选取同期体检60例健康志愿者纳入健康组。采用酶联免疫吸附法检测3组受试者血清肌肉生长抑素、多配体蛋白聚糖-1水平。随访2年,记录肝癌患者存活、死亡情况,分析血清肌肉生长抑素、多配体蛋白聚糖-1与患者预后的关系。结果健康组血清肌肉生长抑素、多配体蛋白聚糖-1水平均低于非肝癌组和肝癌组,非肝癌组血清肌肉生长抑素、多配体蛋白聚糖-1水平均低于肝癌组,差异有统计学意义(P<0.05)。死亡组患者血清肌肉生长抑素、多配体蛋白聚糖-1水平均高于存活组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清甲胎蛋白、肌肉生长抑素、多配体蛋白聚糖-1是影响酒精性肝硬化转肝癌患者预后的独立危险因素(P<0.05)。受试者工作特征曲线结果显示,血清肌肉生长抑素预测患者预后的曲线下面积为0.804,敏感度和特异度分别为0.702、0.810;多配体蛋白聚糖-1预测患者预后的曲线下面积为0.829,敏感度和特异度分别为0.723、0.751;两项联合检测预测患者预后的曲线下面积为0.910,敏感度和特异度分别为0.788、0.879。结论血清肌肉生长抑素、多配体蛋白聚糖-1水平是影响肝癌患者预后的重要危险因素,两者联合检测对评估肝癌患者预后有一定参考价值。

Objective To evaluate the value of serum myostatin and syndecan-1 on the risk and prognosis of liver cancer in patients with alcoholic cirrhosis.Methods A retrospective study was performed on 159 cases of patients with alcoholic liver cirrhosis who were admitted from January 2015 to December 2017.Patients were divided into liver cancer group(n=68)and non-liver cancer group(n=91)according to the occurrence of liver cancer.Another 60 healthy volunteers who had physical examination during the same period were included in the healthy group.Serum levels of myostatin and syndecan-1 were detected by enzyme-linked immunosorbent assay.The patients were followed up for 2 years,and the survival and death of the liver cancer patients were recorded.The relationship between serum myostatin,syndecan-1 and the prognosis of the patients was analyzed.Results Serum levels of myostatin and syndecan-1 in healthy group were lower than those in non-liver cancer group and liver cancer group,and those in non-liver cancer group were lower than those in liver cancer group,with statistically significant differences(P<0.05).Serum myostatin and syndecan-1 levels in the death group were higher than those in the survival group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that serum alpha-fetoprotein,myostatin and syndecan-1 were independent risk factors for prognosis of patients with alcoholic liver cirrhosis transferred to liver cancer(P<0.05).Receiver operating characteristics curve results showed that the area under the curve of serum myostatin for predicting the prognosis was 0.804,and the sensitivity and specificity were 0.702 and 0.810,respectively.The area under the curve of syndecan-1 for predicting the prognosis was 0.829,the sensitivity and specificity were 0.723 and 0.751,respectively.The area under the curve of the two combined tests for predicting the prognosis was 0.910,the sensitivity and specificity were 0.788 and 0.879,respectively.Conclusion Serum myostatin and syndecan-1 levels are important risk factors affecting the prognosis of patients with liver cancer,and their combined detection has certain reference value in evaluating the prognosis of patients with liver cancer.