摘要
目的探讨血清异常凝血酶原(PIVKA-Ⅱ)在中晚期肝细胞癌(HCC)患者血清中的表达及与临床病理特征和预后的关系。方法采用化学发光法分别对105例中晚期HCC患者、93例良性肝病患者、90例健康人的血清PIVKA-Ⅱ、AFP水平进行检测;Kaplan-Meier法绘制生存曲线,Log-rank检验进行生存差异比较;单因素、多因素Cox比例风险回归模型分析影响患者预后的独立危险因素;ROC曲线分析血清PIVKA-Ⅱ、AFP的诊断效能。结果中晚期肝癌组血清PIVKA-Ⅱ和AFP水平显著高于良性肝病组和对照组(均P <0.05);血清PIVKA-Ⅱ高表达与肿瘤大小、肿瘤数目、血管侵犯和TNM分期有关(均P <0.05);低表达组5年总体生存期(OS)和5年无进展生存期(PFS)显著高于高表达组(均P <0.05);多因素分析显示血清PIVKA-Ⅱ表达是影响中晚期肝癌患者5年OS、PFS的独立危险因素(均P <0.05);ROC曲线分析显示PIVKA-Ⅱ和AFP联合检测可显著提高诊断效能。结论 PIVKA-Ⅱ在中晚期肝癌患者血清中表达上调,其高表达与多种不良临床病理特征及预后密切相关,可作为判断中晚期肝癌患者预后的重要生物标志物。
Objective To explore the expression of serum protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)in advanced hepatocellular carcinoma(HCC)and its relationship with clinicopathological characteristics and prognosis. Methods Chemiluminescence method was used to detect serum PIVKA-Ⅱ and AFP levels in105 patients with advanced HCC,93 patients with benign hepatic diseases,and 90 healthy volunteers;survival analysis was performed by Kaplan-Meier method and Log-rank test;univariate and multivariate analysis were performed using the Cox proportional hazard analysis;the receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum PIVKA-Ⅱ and AFP in diagnosing of advanced HCC. Results The expression levels of PIVKA-Ⅱ and AFP in advanced HCC group were significantly higher than those in benign hepatic diseases and control group(P < 0.05);the high-expression of PIVKA-Ⅱ in advanced HCC patients were correlated with the tumor size,tumor number,vascular invasion and TNM stag(P < 0.05);the 5-year OS and PFS in low-expression group were significantly better than those in high-expression group(P < 0.05);PIVKA-Ⅱ high-expression was independent risk factors affecting 5-year OS and PFS in advanced HCC patients(P < 0.05);the AUC of the combined detection of the two in the diagnosis of HCC is significantly higher than that of single detection(P <0.05). Conclusion PIVKA-Ⅱ was up-regulated in advanced HCC patients and its high-expression was closely related with several unfavorable clinicopathological features and prognosis,and it might be an important biomarker for predicting the prognosis of advanced HCC.
作者
薄维波
秦继宝
陈隽
陶祥平
章勇
闫朝春
朱洪波
郭加友
安仲武
BO Weibo;QIN Jibao;CHEN Jun;TAO Xiangping;ZHANG Yong;YAN Chaochun;ZHU Hongbo;GUO Jiayou;AN Zhongwu(Department of Clinical Laboratory,Lianyungang Oriental Hospital Affiliated to Xuzhou Medical University,Lianyungang 222042,China)
出处
《实用医学杂志》
CAS
北大核心
2021年第23期3036-3040,共5页
The Journal of Practical Medicine
基金
江苏省连云港市卫生科技项目(编号:201927)。
关键词
中晚期肝癌
血清异常凝血酶原
表达
预后
advanced hepatocellular carcinoma
protein induced by vitamin K absence or antagonist-Ⅱ
expression
prognosis