血浆外泌体A1BG-AS1对原发性肝癌诊断及预后评估价值

Value of plasma exosomes A1BG-AS1 in the diagnosis and prognosis evaluation of primary hepatic carcinoma

目的 探讨原发性肝癌(PHC)患者血浆外泌体A1BG反义RNA 1(A1BG-AS1)表达情况及其对PHC的诊断及预后评估价值。方法 选取2016年12月至2018年6月在该院治疗的75例PHC患者作为PHC组,26例单纯肝硬化患者作为肝硬化组,另选取同期50例体检健康者作为对照组,采用实时荧光定量PCR(RT-qPCR)检测血浆外泌体A1BG-AS1表达水平,分析A1BG-AS1表达水平与临床病理特征关系,采用受试者工作特征(ROC)曲线分析血浆外泌体A1BG-AS1对PHC的诊断价值,Kaplan-Meier法分析PHC患者生存曲线,Cox回归模型分析影响PHC患者预后的危险因素。结果 对照组、肝硬化组、PHC组血浆外泌体A1BG-AS1表达水平比较,差异有统计学意义(P<0.01),其中肝硬化组、PHC组血浆外泌体A1BG-AS1表达水平明显低于对照组(P<0.01);PHC组血浆外泌体A1BG-AS1表达水平明显低于肝硬化组(P<0.01)。A1BG-AS1、AFP联合检测诊断PHC的曲线下面积(AUC)为0.898(95%CI:0.839~0.941),约登指数为0.657,灵敏度为90.67%,特异度为75.00%。PHC患者血浆外泌体A1BG-AS1表达水平与肿瘤分期、肝功能分级和淋巴结转移有关(P<0.05)。Kaplan-Meier生存分析显示,A1BG-AS1高表达PHC患者的3年生存率明显高于A1BG-AS1低表达PHC患者(χ^(2)=6.857,P=0.009)。肿瘤分期为T3~T4、有淋巴结转移、A1BG-AS1低表达是影响PHC患者预后的独立危险因素(P<0.05)。结论 PHC患者血浆外泌体A1BG-AS1低表达,其与临床病理特征和预后有关,血浆外泌体A1BG-AS1、AFP联合检测对PHC有较高诊断价值,可作为PHC诊断与预后判断的标志物。

Objective To investigate the expression of A1 BG antisense RNA 1(A1 BG-AS1) in plasma exosomes of patients with primary hepatic carcinoma(PHC) and its value in the diagnosis and prognosis evaluation of PHC.Methods Seventy-five PHC patients treated in this hospital from December 2016 to June 2018 were selected as PHC group and twenty-six patients with simple liver cirrhosis were selected as cirrhosis group.In addition,50 healthy controls in the same period were selected as control group.The relative expression of plasma exosomes A1 BG-AS1 was detected by real-time fluorescence quantitative PCR(RT-qPCR),and the relationship between the expression level of plasma exosome A1 BG-AS1 and clinicopathological characteristics was analyzed.The diagnostic value of plasma exosome A1 BG-AS1 for PHC patients was analyzed by receiver operating characteristic(ROC) curve.The survival curve of PHC patients was analyzed by Kaplan-Meier method,and the prognostic risk factors of PHC patients were analyzed by Cox regression model.Results Comparison of plasma exosome A1 BG-AS1 expression levels among control group,cirrhosis group and PHC group showed statistically significant difference(P<0.01).The expression level of plasma exosomes A1 BG-AS1 in the cirrhosis group and PHC group was significantly lower than that in the control group(P<0.01),and the expression level of plasma exosomes A1 BG-AS1 in the PHC group was significantly lower than that in the cirrhosis group(P<0.01).The area under the curve(AUC) of A1 BG-AS1 combined with AFP in the diagnosis of PHC was 0.898(95%CI:0.839-0.941),the Youden index was 0.657,the sensitivity was 90.67%,and the specificity was 75.00%.The expression level of plasma exosomes A1 BG-AS1 in PHC patients was correlated with tumor stage,liver function grade and lymph node metastasis(P<0.05).Kaplan-Meier survival analysis showed that the 3-year survival rate of patients with high A1 BG-AS1 expression was significantly higher than that of patients with low A1 BG-AS1 expression(χ^(2)=6.857,P=0.009).Tumor staging(T3-T4),lymph node metastasis,and low expression of A1 BG-AS1 were independent risk factors that affected the prognosis of PHC patients(P<0.05).Conclusion Plasma exosomes A1 BG-AS1 expressed lowly in PHC patients,and it is related to clinicopathological characteristics and prognosis.The combination of plasma exosomes A1 BG-AS1 and AFP has a high diagnostic value for PHC and can be used as a marker for the diagnosis and prognosis of PHC.