术前血清VEGF、HMGB1及HIF-1α对无法切除的肝细胞癌患者TACE术后预后的预测价值

Predictive Value of Preoperative Serum VEGF,HMGB1 and HIF-1αon the Prognosis of Patients with Unresectable Hepatocellular Carcinoma after

目的:探讨术前血清血管内皮生长因子(VEGF)、高迁移率族蛋白B1(HMGB1)及缺氧诱导因子-1α(HIF-1α)对无法切除的肝细胞癌(HCC)患者经动脉化疗栓塞(TACE)术后预后的预测价值。方法:选取2018年6月~2021年6月湖南中医药高等专科学校附属第一医院收治的240例无法行根治性切除术的HCC患者,根据TACE术后1年预后情况分为预后不良组和预后良好组。采用酶联免疫吸附法检测术前血清VEGF、HMGB1及HIF-1α水平,分析三者与HCC患者临床病理特征的关系。采用多因素Logistic回归分析HCC患者TACE术后预后不良的影响因素,采用受试者工作特征(ROC)曲线分析术前血清VEGF、HMGB1及HIF-1α水平对HCC患者TACE术后预后不良的预测价值。结果:HCC患者术前VEGF、HMGB1及HIF-1α水平与Child-Pugh分级、分化程度和血管侵犯有关(P<0.05)。随访1年,240例HCC患者TACE术后预后不良发生率为25.42%(61/240)。多因素Logistic回归分析显示,Child-Pugh分级B级、甲胎蛋白≥400μg/L、血管侵犯和VEGF、HMGB1、HIF-1α升高为HCC患者TACE术后预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,术前血清VEGF、HMGB1及HIF-1α水平联合预测HCC患者TACE术后预后不良的曲线下面积大于VEGF、HMGB1、HIF-1α单独预测。结论:术前血清VEGF、HMGB1及HIF-1α水平升高与HCC患者TACE术后预后不良有关,三者联合预测HCC患者TACE术后预后不良的价值较高。

Objective:To investigate the predictive value of preoperative serum vascular endothelial growth factor(VEGF),high mobility group protein B1(HMGB1)and hypoxia-inducible factor-lα(HIF-1α)on the prognosis of patients with unresectable hepatocellular carcinoma(HCC)after transarterial chemoembolization(TACE).Methods:240 HCC patients who cannot undergo radical resectio and were admitted to The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from June 2018 to June 2021 were selected,and they were divided into poor prognosis group and good prognosis group according to their prognosis at 1 year after TACE.The preoperative serum VEGF,HMGB1 and HIF-1α levels were measured by enzyme-linked immunosorbent assay,Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with HCC after TACE,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative serum VEGF,HMGB1 and HIF-1αlevels on poor prognosis in patients with HCC afer TACE.Results:Preoperative VEGF,HMGB1 and HIF-1αlevels in patients with HCC were associated with Child-Pugh classification,degree of differentiation and vascular invasion(P<0.05).At 1 year follow-up,the incidence of poor prognosis after TACE in 240 patients with HCC was 25.42%(61/240).Multi-factor Logistic regression analysis showed that Child-Pugh classification grade B,methemoglobin≥400μg/L,vascular invasion and elevated VEGF,HMGB1 and HIF-1α were independent risk factors for poor prognosis in patients with HCC after TACE(P<0.05).ROC curve analysis showed that the area under curve for preoperative serum VEGF,HMGB1 and HIF-1αlevels combined to predict poor prognosis in patients with HCC after TACE was greater than that predicted by VEGF,HMGB1 and HIF-1α alone.Conclusion:Preoperative elevated serum VEGF,HMGB1 and HIF-lαlevels are associated with poor prognosis in patients with HCC after TACE,and the combination of the three has of high value in predicting poor prognosis in patients with HCC after TACE.