血清GDF-15、CTCs在肝细胞癌患者中的表达及与预后的关系

Expressions of serum GDF-15 and CTCs in hepatocellular carcinoma patients andtheir relationship with prognosis

目的 观察肝细胞癌患者血清生长分化因子15(GDF-15)、循环肿瘤细胞(CTCs)水平,分析二者与术后患者预后的关系。方法 选择2018年1月至2021年1月该院收治的102例肝细胞癌患者作为观察组,纳入同期该院收治的102例肝脏良性疾病患者作为对照组,检测两组血清GDF-15、CTCs水平。全部肝细胞癌患者均接受手术治疗,术后进行为期1年的随访,观察患者术后复发情况,以术后是否复发作为评估患者预后的标准,分为预后不良组、预后良好组。收集肝细胞癌患者基线资料和相关实验室指标,采用COX回归分析肝细胞癌术后患者预后的影响因素;绘制受试者工作特征(ROC)曲线,分析血清GDF-15、CTCs预测术后患者预后的价值。结果 与对照组比较,观察组血清GDF-15、CTCs水平均升高,差异均有统计学意义(P<0.05);肝细胞癌手术患者中有16例患者出现复发,复发率为15.69%(16/102);预后不良组血清甲胎蛋白(AFP)、GDF-15、CTCs水平均高于预后良好组,差异均有统计学意义(P<0.05);COX回归分析结果显示,血清AFP、GDF-15和CTCs水平升高是肝细胞癌术后患者预后的影响因素(P<0.05);ROC曲线分析结果显示,血清GDF-15、CTCs单独及联合预测肝细胞癌术后患者预后的曲线下面积分别为0.751、0.741、0.810,均具有一定的预测价值,但以联合预测的价值最高。结论 血清GDF-15、CTCs在肝细胞癌患者中水平明显升高,且与术后患者的预后有关。

Objective To observe the levels of serum growth differentiation factor 15(GDF-15)and circulating tumor cells(CTCs)in the patients with hepatocellular carcinoma(HCC),and to analyze their relationship with postoperative prognosis.Methods A total of 102 patients with HCC admitted and treated in this hospital from January 2018 to January 2021 were selected as the observation group,and 102 patients with benign liver diseases admitted and treated in this hospital during the same period were included as the control group.The levels of serum GDF-15 and CTCs in the two groups were detected.All patients with HCC received the surgery and the 1-year followed up.The postoperative recurrence was observed and whether the postoperative recurrence served as the standard for evaluating the prognosis of the patients.The patients with HCC were divided into the poor prognosis group and good prognosis group.The baseline data and related laboratory indexes of the patients with HCC were collected,and the COX regression was adopted to analyze the postoperative influencin g factors in the patients with HCC;the receiver operating characteristic(ROC)curve was drawn and the value of serum GDF-15 and CTCs in predicting postoperative prognosis was analyzed.Results Compared with the control group,the l evels of serum GDF-15 and CTCs in the observation group were significantly increased,the difference was statistically significant(P<0.05);among the operative patients with HCC,16 cases had recurrence with the recurrence rate of 15.69%(16/102);the levels of serum AFP,GDF-15 and CTCs in the poor prognosis group were higher than those in the good prognosis group,the difference was statistically significant(P<0.05);the COX regression analysis results showed that serum AFP,GDF-15 and CTCs levels increase were the influencing factors of the prognosis after operation in the patients with HCC(P<0.05);the ROC curve analysis results showed that the area under the curve(AUC)of serum GDF-15 and CTCs single detection and their combination detection for predicting the prognosis in the postoperative patients with HCC were 0.751,0.741 and 0.810 respectively.All had certain predictive value,but the combined detection had the highest prediction value.Conclusion The expression of serum GDF-15 and CTCs in the patients with HCC is significantly increased,moreover which is related to the postoperative prognosis.