转化生长因子-β1、细胞角蛋白19、中性粒细胞与淋巴细胞比值对中晚期肝癌调强放疗患者预后的预测价值

Predictive value of transforming growth factor-β1,cytokeratin 19,and neutrophil�to-lymphocyte ratio for the prognosis of patients with advanced liver cancer undergoing intensity-modulated radiotherapy

目的探讨转化生长因子-β1(TGF-β1)、细胞角蛋白19(CK19)、中性粒细胞与淋巴细胞比值(NLR)单独及联合检测对中晚期肝癌调强放疗患者预后的预测价值。方法选取72例中晚期肝癌患者,均接受调强放疗,随访4个月,记录患者的预后情况,比较不同预后中晚期肝癌调强放疗患者TGF-β1、CK19水平和NLR。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估TGF-β1、CK19、NLR单独和联合检测对中晚期肝癌调强放疗患者预后的预测价值。结果随访4个月,72例肝癌调强放疗患者中,预后良好43例,预后不良29例。放疗后,预后不良患者TGF-β1、CK19水平和NLR均明显高于预后良好患者,差异均有统计学意义(P﹤0.01)。ROC曲线显示,TGF-β1、CK19、NLR联合检测预测中晚期肝癌调强放疗患者预后的AUC为0.894(95%CI:0.799~0.954),高于各指标单独检测,灵敏度为79.31%,特异度为93.02%。结论TGF-β1、CK19、NLR联合检测预测中晚期调强放疗患者预后的价值较好。

Objective To analyze the predictive value of single and combined detection of transforming growth factor-β1(TGF-β1),cytokeratin 19(CK19),and neutrophil-to-lymphocyte ratio(NLR)for the prognosis of patients with advanced liver cancer undergoing intensity-modulated radiotherapy(IMRT).Method A total of 72 patients with advanced liver cancer who received IMRT were selected,and followed up for 4 months after the treatment,the prognosis was recorded,and the levels of TGF-β1,CK19,and NLR in advanced liver cancer patients underwent IMRT with different prognosis were compared.The receiver operating characteristic(ROC)curve was draw,the area under the curve(AUC)was calculated,and the predictive value of TGF-β1,CK19,and NLR single and combined detection for the prognosis of advanced liver cancer patients undergoing IMRT were evaluated.Result After 4 months followed up,43 cases had a good prognosis,29 cases had a poor prognosis among the 72 patients with liver cancer undergoing IMRT.After radiotherapy,the levels of TGF-β1,CK19,and NLR in patients with poor prognosis were higher than those in patients with good prognosis,and the differences were statistically significant(P<0.01).The ROC curve showed that,the AUC of TGF-β1,CK19,and NLR combined detection to predicted the prognosis of advanced liver cancer patients underwent IMRT was 0.894(95%CI:0.799-0.954),which was higher than the single detection of each indicator,the sensitivity was 79.31%,and the specificity was 93.02%.Conclusion The combined detection of TGF-β1,CK19,and NLR has a good value in predicting the prognosis of advanced liver cancer patients underwent IMRT.