内质网氨肽酶-1在HCC中的表达及预后的相关性研究

Expression of ERAP1 in patients with hepatocellular carcinoma and its correlation with prognosis

目的探讨外周血内质网氨肽酶-1(ERAP1)水平对肝细胞肝癌(HCC)病情严重程度和预后的诊断价值。方法采用酶联免疫吸附实验(ELISA)检测HCC患者、肝硬化患者及健康对照(HC)血清ERAP1水平;分析ERAP1和临床各项指标的相关性,采用多因素Logistic回归分析病情程度和预后的独立危险因素。受试者工作曲线(ROC)评估ERAP1在诊断不同病情程度和预后的敏感性和特异性。结果HCC患者血清ERAP1水平与HC组、肝硬化组比较,差异有统计学意义(P<0.05),ERAP1水平与肿瘤分期、大小及病灶数目均呈显著相关性(均P<0.05);ERAP1水平与丙氨酸氨基转移酶(ALT)、血清天冬氨酸氨基转移酶(AST)、血清总胆红素(TBIL)、甲胎蛋白(AFP)均呈正相关,与ALB呈负相关(P<0.05)。多因素Logistic回归分析显示ERAP1为病情程度和不同预后的独立预测因素。ERAP1和AFP联合诊断早期HCC的曲线下面积(AUC)为0.932;诊断不良预后时AUC为0.742。结论ERAP1水平在评估HCC患者病情程度和预后方面具有重要的临床意义和潜在应用价值。

Objective To investigate the diagnostic endoplasmic reticulum aminopeptidase-1(ERAP1)in patients with hepatocellular carcinomae(HCC).Methods Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of ERAP1 in HCCpatients,cirrhosis patients and healthy controls(HC).Multivariate logistic regression was used to analyze the independent risk factors of the severity and prognosis,and receiver operating characteristic curve(ROC)was used to evaluatesensitivity and specificity of ERAP1 in the diagnosis of different degree of disease and prognosis.Results The serum ERAP1 level of HCC was related to tumor stage,tumor size and number of cancer focal(P<0.05).ERAP1 level of HCC patients was positivecorrelated with ALT,AST,TBIL and AFP,while negative correlated with ALB(P<0.05).ERAP1 was found to be an independent predictor of different severity and prognosis.When joint diagnosing HCC with AFP,the area under the curve(AUC)was 0.932.For the diagnosis of poor prognosis,the AUC was 0.742.Conclusion Serum ERAP1 level has important clinical significance and potential application value in evaluating the severity and prognosis of HCC patients.