血清热休克蛋白70对原发性肝癌患者TACE治疗预后的预测价值

Prognostic value of serum HSP70 on prognosis of TACE therapy in patients with primary liver cancer

目的研究血清热休克蛋白70(HSP70)对原发性肝癌患者经肝动脉导管化疗栓塞(TACE)治疗预后的预测价值。方法选取2018年9月至2019年9月在我院接受TACE治疗的中晚期原发性肝癌患者作为肝癌组,同期体检的健康志愿者作为对照组,检测肝癌组患者术前及术后1 d、7 d、14 d时的血清HSP70水平及对照组的血清HSP70水平,随访肝癌组患者TACE术后的复发情况并计算其无进展生存期,采用Log-rank检验分析无进展生存期的差异,采用Cox回归模型分析无进展生存期的影响因素,采用ROC曲线分析HSP70对复发的预测价值。结果肝癌组患者血清HSP70的水平明显高于对照组(P<0.05),肝癌组中复发患者术前及术后1 d时的血清HSP70水平与无进展患者比较,差异无统计学意义(P>0.05),但术后7 d及14 d时的血清HSP70水平高于无进展患者(P<0.05);与术后7 d及14 d时HSP70低水平患者比较,HSP70高水平患者的无进展生存期缩短(P<0.05);肿瘤最大直径、血管侵犯、术后7 d时HSP70水平是无进展生存期的影响因素(P<0.05);术后7 d时的血清HSP70水平对术后复发具有预测价值。结论中晚期原发性肝癌患者TACE术后7 d时血清HSP70水平升高与术后复发有关,且对术后复发具有预测价值。

Objective To study the prognostic value of serum heat shock protein 70(HSP70)on prognosis of transcatheter arterial chemo embolization(TACE)therapy in patients with primary liver cancer.Methods From Sep.2018 to Sep.2019,the patients with advanced primary liver cancer who received TACE therapy in our hospital were selected as the liver cancer group,and the healthy volunteers who received physical examination at the same time as the control group.The serum HSP70 level of the patients in the liver cancer group before operation and at 1 day,7 days and 14 days after operation and the serum HSP70 level of control group were detected.The recurrence of the patients after TACE was followed up and the progression free survival was calculated.Log-rank test was used to analyze the difference of progression free survival,Cox regression model was used to analyze the influencing factors of progression free survival,ROC curve was used to analyze the predictive value of HSP70 on recurrence.Results The level of serum HSP70 in liver cancer group was significantly higher than that in the control group(P<0.05),and there was no difference of serum HSP70 levels before and 1 day after operation between patients without progression and recurrence(P>0.05),and the progression free survival of patients with recurrence at 7 days and 14 days after operation were higher than those of patients without progression(P<0.05);compared with patients with low level of HSP70 at 7 days and 14 days after operation,the progression free survival in patients with high level of HSP70 was shortened(P<0.05).The maximum diameter of tumor,vascular invasion and HSP70 level at 7 days after operation were the influencing factors of progression free survival(P<0.05).The serum HSP70 level at 7 days after operation had predictive value for postoperative recurrence.Conclusion The increase of serum HSP70 level at 7 days after TACE is related to postoperative recurrence and has predictive value for postoperative recurrence.