PPP2R3A表达与乙型肝炎相关肝癌易感性及患者预后的关系

Relationship between PPP2R3A expression and susceptibility to hepatitis B related liver cancer and patient prognosis

目的探讨PPP2R3A表达水平与乙型肝炎相关性肝癌易感性及患者预后的关系。方法选择2020年1月至2021年6月秦皇岛市第三医院收治的60例慢性乙型肝炎肝硬化患者(肝硬化组)和120例慢性乙型肝炎肝硬化癌变患者(肝癌组)作为研究对象。采用免疫组织化学染色法和ELISA法检测2组的病变肝组织和血清中PPP2R3A表达水平,分析肝癌组的血清PPP2R3A表达水平与患者临床病理特征的关系,以及肝癌组的病变肝组织中PPP2R3A表达与患者预后的关系。结果肝癌组病变肝组织中PPP2R3A高表达率显著高于肝硬化组(64.2%%比23.3%,P<0.05)。肝癌组的血清PPP2R3A表达水平显著高于肝硬化组[(14.05±4.68)ng/mL比(11.36±2.99)ng/mL,t=3.669,P<0.001]。肝癌组患者中,T2~T3期、血清DCP≥2000 ng/mL、AFP-L3%阳性和HBV-DNA表达阳性的患者的血清PPP2R3A表达水平分别较T1期、血清DCP<2000 ng/mL、AFP-L3%阴性和HBV-DNA表达阴性的患者显著升高(P均<0.05)。病变肝组织中PPP2R3A高表达组的1年总生存率显著低于低表达组(χ^(2)=4.546,P=0.033)。二分类Logistic回归分析结果显示,肝癌患者病变肝组织中PPP2R3A高表达、T2~T3期、AFP-L3%阳性及血清DCP水平升高均为患者预后的独立危险因素(P均<0.05)。结论PPP2R3A在肝癌患者血清和病变肝组织中均呈高表达,且与不良预后相关,是肝癌患者生存的独立危险因素,也是肝癌患者早期诊断和预后预测的潜在指标。

Objective This paper intends to explore the relationship between PPP2R3A expression and the susceptibility and prognosis of hepatitis B related liver cancer.Methods Sixty patients with chronic hepatitis B cirrhosis(cirrhosis group)and 120 patients with chronic hepatitis B cirrhosis and cancerous transformation(liver cancer group)admitted to the Third Hospital of Qinhuangdao from January 2020 to June 2021 were selected as the research subjects.The immunohistochemical staining and ELISA were used to detect the expression levels of PPP2R3A in the diseased liver tissue and serum of the two groups.The relationship between serum PPP2R3A expression levels in the liver cancer group and clinical pathological characteristics of patients,as well as the relationship between PPP2R3A expression in the diseased liver tissue of the liver cancer group and prognosis were analyzed.Results The high expression rate of PPP2R3A in the liver tissue of the liver cancer group is significantly higher than that in the liver cirrhosis group(64.2%%versus 23.3%,P<0.05).The serum PPP2R3A expression level in the liver cancer group is significantly higher than that in the liver cirrhosis group((14.05±4.68)ng/mL versus(11.36±2.99)ng/mL,t=3.669,and P<0.001).In the liver cancer group,the serum PPP2R3A expression levels in patients with T2-T3 stage,serum DCP≥2000 ng/mL,AFP-L3%positive,and HBV-DNA expression positive are significantly higher than those in patients with T1 stage,serum DCP<2000 ng/mL,AFP-L3%negative,and HBV-DNA expression negative,respectively(P<0.05).The 1-year overall survival rate of the PPP2R3A high expression group in diseased liver tissue is significantly lower than that of the low expression group(χ^(2)=4.546 and P=0.033).The binary logistic regression analysis shows that the high expression of PPP2R3A in the diseased liver tissue,T2-T3 stage,positive AFP L3%,and elevated serum DCP levels of liver cancer patients are independent risk factors for patient prognosis(P<0.05).Conclusions PPP2R3A is highly expressed in the serum and diseased liver tissue of liver cancer patients,and is associated with poor prognosis.It is an independent risk factor for the survival of liver cancer patients and a potential indicator for early diagnosis and prognosis prediction of liver cancer patients.