摘要
目的探讨血清缺氧诱导因子1α(HIF-1α)水平与原发性肝细胞癌(HCC)患者经射频消融术(RFA)治疗后复发/生存的关系。方法收集2013年1月至2017年12月在我院接受RFA一线治疗的578例HCC患者作为研究对象。治疗前48 h内采集空腹外周血标本5 ml,采用酶联免疫吸附法检测血清HIF-1α水平。随访至2021年12月31日,记录患者复发和死亡情况。Logistic回归模型分型影响HCC患者RFA治疗后复发的因素,Cox风险比例模型分析影响HCC患者RFA治疗后生存的影响因素。结果HCC患者血清HIF-1α基线水平为996.22 pg/ml(537.99 pg/ml,1626.98 pg/ml),且与病灶数量、血清α-甲胎蛋白和α-甲胎蛋白异质体(AFP-L3)水平、Metavir纤维化分期、Metavir炎症分级有关(P<0.05)。随访期间,共有497例患者复发,278例患者死亡。Logistic回归模型和Cox风险比例回归模型分析,血清HIF-1α基线水平≥537.99 pg/ml影响复发(HR=1.122,95%CI:1.033~1.220,P=0.006)和生存(HR=1.297,95%CI:1.159~1.451,P<0.001)的独立预测因素。结论血清HIF-1α水平是影响HCC患者RFA治疗后复发和生存预后的独立预测因子。
Objective To investigate the relationship between serum hypoxia-inducing factor 1α(HIF-1α)levels and recurrence/survival in patients with primary hepatocellular carcinoma(HCC)after radiofrequency ablation(RFA).Methods Five hundred and seventy-eight HCC patients who received RFA first-line treatment in our hospital from January 2013 to December 2017 were collected as the study objects.Five ml of fasting peripheral blood samples were collected within 48 h before treatment,and serum HIF-1αlevel was detected by enzyme-linked immunosorbent assay.Patients were followed up until December 31,2021 to record relapse and death.Logistic regression model was used to classify the factors affecting the relapse of HCC patients after RFA treatment,and Cox risk ratio model was used to analyze the factors affecting the survival of HCC patients after RFA treatment.Results The baseline level of serum HIF-1αin HCC patients was 996.22 pg/ml(537.99 pg/ml,1626.98 pg/ml).It was also related to the number of lesions,the level ofα-fetoprotein andα-fetoprotein(AFP-L3)in serum,Metavir fibrosis stage and Metavir inflammation grade(P<0.05).During follow-up,497 patients relapsed and 278 patients died.Logistic regression model and Cox proportional regression model analysis showed that serum HIF-1α≥537.99 pg/ml at baseline affected recurrence(HR=1.122,95%CI:1.033-1.220,P=0.006)and survival(HR=1.297,95%CI:1.159 to 1.451,P<0.001).Conclusion Serum HIF-1αlevel is an independent predictor of relapse and survival after RFA treatment in HCC patients.
作者
郝名浩
王俊毅
刘萍萍
林志伟
陈大朝
HAO Minghao;WANG Junyi;LIU Pingping;LIN Zhiwei;CHEN Dachao(Department of Oncology,Southeast Hospital Affiliated to Xiamen University,Xiamen 363000)
出处
《临床肿瘤学杂志》
2023年第10期913-919,共7页
Chinese Clinical Oncology
关键词
原发性肝细胞癌
缺氧诱导因子1Α
射频消融术
复发
生存预后
Primary hepatocellular carcinoma
Hypoxia-inducible factors 1α
Radiofrequency ablation
Recurrence
Survival prognosis