中晚期原发性肝癌患者经导管肝动脉化疗栓塞术前后血清抗Survivin抗体变化及其与患者预后的关系

Changes of serum anti survivin antibody in patients with advanced primary liver cancer before and after TACE and its relationship with prognosis

目的探讨中晚期原发性肝癌患者经导管肝动脉化疗栓塞术(transcatheter hepatic arterial chemoembolization,TACE)前后血清抗Survivin抗体变化及其与患者预后的关系。方法选择同仁医院收治的中晚期原发性肝癌患者103例,均行TACE术治疗,检测患者术前1 d、术后1个月血清抗Survivin抗体表达水平。分析血清抗Survivin抗体水平变化与患者肿瘤近期治疗疗效、临床病理特征及预后的关系。结果疾病缓解患者术后抗Survivin抗体水平显著低于疾病未缓解患者(81.84±9.30比90.84±10.21,P<0.05),疾病缓解患者抗Survivin抗体变化显著高于疾病未缓解患者(30.93±5.63比22.75±4.52,P<0.05)。TACE手术前后,抗Survivin抗体变化与患者TNM分期、肿瘤最大径及分化程度有关(P<0.05)。生存情况分析结果显示,△抗Survivin抗体减少患者术后生存情况显著优于△抗Survivin抗体未减少患者(P<0.05)。△抗Survivin抗体预测原发性肝癌患者1年内死亡的价值,ROC曲线下面积为0.850。结论中晚期肝癌患者TACE手术前后抗Survivin抗体变化差异与患者近远期疗效有关。

Objective To investigate the expression of anti apoptosis inhibitor antibody in serum of patients with advanced primary liver cancer and its relationship with the prognosis after transcatheter hepatic arterial chemoembolization(TACE).Methods One hundred and three patients with advanced primary liver cancer were selected from our hospital and treated with TACE.Serum anti-survivin antibody expression levels were detected 1 day before surgery and 1 month after surgery.To analyze the relationship between serum anti-survivin antibody level and short-term therapeutic effect,clinicopathological features and prognosis were analyzed.Results the level of anti-survivin antibody in patients with disease remission was significantly lower than that in patients without disease remission(81.84±9.30 vs.90.84±10.21,P<0.05),and the change of anti-survivin antibody in patients with disease remission was significantly higher than that in patients without disease remission(30.93±5.63 vs.22.75±4.52,P<0.05).The changes of anti-survivin antibody before and after TACE were correlated with TNM stage,maximum tumor diameter and degree of differentiation(P<0.05).The results of survival analysis showed that the postoperative survival of patients with△reduced anti-survivin antibody was significantly better than that of patients without△reduced anti-survivin antibody(P<0.05).The area under the ROC curve was 0.850 in the prediction of one-year death value of patients with primary liver cancer by△anti-survivin antibody.Conclusion the difference of anti survivin antibody before and after TACE in patients with advanced liver cancer is closely related to the short-term and long-term prognosis.