双同源异型盒A假基因8评价经TACE治疗的肝癌肾上腺转移患者预后的价值

The Value of Double Homeobox A Pseudogene 8 in Evaluating the Prognosis of Liver Cancer Patients with Adrenal Metastasis Treated with TACE

目的探究长链非编码RNA(lncRNA)双同源异型盒A假基因8(DUXAP8)评价经导管肝动脉化疗栓塞术(TACE)治疗的肝癌肾上腺转移患者预后的价值。方法选择2012年4月至2018年1月就诊的79例肝癌肾上腺转移患者作为研究对象,并根据预后分为生存组(n=34)和死亡组(n=45)。用实时荧光定量PCR法检测DUXAP8表达量,用Cox回归分析经TACE治疗的肝癌肾上腺转移预后的风险因素,用受试者工作特征(ROC)曲线评价DUXAP8诊断经TACE治疗的肝癌肾上腺转移预后的价值。结果生存组DUXAP8的相对表达量低于死亡组,差异有统计学意义(P<0.05)。Cox多因素分析结果显示DUXAP8是经TACE治疗的肝癌肾上腺转移预后的独立危险因素(P<0.05),接受索拉非尼治疗是经TACE治疗的肝癌肾上腺转移预后的独立保护因素(P<0.05)。DUXAP8评价经TACE治疗的肝癌肾上腺转移预后的ROC曲线下面积(AUC)、灵敏度和特异度分别为0.915、82.2%和91.2%。按1∶1倾向性评分匹配(最邻近原则)后,DUXAP8评价经TACE治疗的肝癌肾上腺转移预后的AUC、灵敏度和特异度分别为0.898、85.7%和100.0%。结论肝癌肾上腺转移病灶内DUXAP8高表达提示接受TACE治疗临床获益较低。

Objective To investigate the value of long-chain non-coding ribonucleic acid double homebox A pseudogene 8(lncRNA DUXAP8) in evaluating the prognosis of liver cancer patients with adrenal metastasis treated with trans-arterial chemoembolization(TACE). Methods A total of 79 patients with adrenal metastases from liver cancer treated from April 2012 to January 2018 were selected as the research subjects, and were divided into survival group(n=34) and death group(n=45) according to the prognosis. Real-time fluorescent quantitative PCR was used to detect the expression of DUXAP8,COX regression analysis was used to analyze the prognostic factors of adrenal metastases from liver cancer treated with TACE,and receiver operating characteristic(ROC) curve was used to evaluate the value of DUXAP8 in diagnosing the prognosis of adrenal metastases from liver cancer treated with TACE. Results The relative expression of DUXAP8 in the survival group was lower than that in the death group, and the difference was statistically significant(P<0.05).Cox multivariate analysis showed that DUXAP8 was independent risk factors for the prognosis of adrenal metastases from liver cancer treated with TACE(P<0.05),the treatment with sorafenib was independent protective factors for the prognosis of adrenal metastases from liver cancer treated with TACE(P<0.05).The area under the ROC curve, sensitivity and specificity of DUXAP8 in assessing the prognosis of adrenal metastases from liver cancer treated with TACE were 0.915,82.2% and 91.2%,respectively.After 1:1 propensity score matching(nearest),the area under the ROC curve, sensitivity and specificity of DUXAP8 in assessing the prognosis of adrenal metastases from liver cancer treated with TACE were 0.898,85.7% and 100.0%,respectively. Conclusion The high expression of DUXAP8 in adrenal metastases of liver cancer suggests that the clinical benefit of TACE is low.