血清SOCS3、TXNIP水平对肝细胞癌TACE治疗预后的预测价值

Predictive value of serum SOCS3 and TXNIP levels for the prognosis of patients with hepatocellular carcinoma treated with TACE

目的探讨血清细胞因子信号传送阻抑物3(SOCS3)、硫氧还蛋白相互作用蛋白(TXNIP)水平对肝细胞癌(HCC)患者经导管动脉化疗栓塞(TACE)治疗预后的预测价值。方法选择2019年12月—2021年7月武汉市汉阳医院收治的107例行TACE治疗的HCC患者作为观察对象,根据TACE治疗后的预后情况,将患者分为预后不良组(n=47)和预后良好组(n=60)。采用酶联免疫吸附试验检测血清SOCS3、TXNIP水平,采用logistic回归分析预后影响因素,受试者操作特征(ROC)曲线分析治疗前血清SOCS3、TXNIP水平对HCC患者TACE治疗预后的预测价值。结果预后良好组与预后不良组患者年龄(χ^(2)=0.56,P=0.453)、性别(χ^(2)=0.06,P=0.800)、肿瘤大小(χ^(2)=1.46,P=0.227)、Child-Pugh分级(χ^(2)=0.26,P=0.608)、肿瘤数量(χ^(2)=0.77,P=0.382)、肝硬化(χ^(2)=0.03,P=0.860)、TACE次数(χ^(2)=0.16,P=0.691)、治疗前甲胎蛋白水平(χ^(2)=0.79,P=0.374)、乙型肝炎病毒表面抗原(χ^(2)=0.58,P=0.446)比较差异均无统计学意义。预后不良组TNM分期为Ⅲ期患者的比例(57.45%,27/47)比预后良好组(25.00%,15/60)高,差异有统计学意义(χ^(2)=11.64,P=0.001)。治疗前预后良好组患者血清SOCS3、TXNIP水平分别为(114.34±20.39)、(45.64±6.41)pg/ml,预后不良组分别为(82.83±15.97)、(34.82±6.36)pg/ml,预后不良组患者血清SOCS3、TXNIP水平均低于预后良好组,差异均有统计学意义(t=8.71,P<0.001;t=8.70,P<0.001);治疗后预后良好组患者血清SOCS3、TXNIP水平分别为(139.65±24.32)、(64.75±7.58)pg/ml,预后不良组分别为(92.41±16.15)、(41.74±7.23)pg/ml,预后不良组血清SOCS3、TXNIP水平均低于预后良好组,差异均有统计学意义(t=11.48,P<0.001;t=15.90,P<0.001);两组患者治疗后血清SOCS3、TXNIP水平均较治疗前显著升高(均P<0.05)。多因素分析显示,TNM分期(OR=2.53,95%CI为1.27~5.02,P=0.008)是HCC患者TACE治疗后预后的独立危险因素,SOCS3(OR=0.65,95%CI为0.44~0.96,P=0.031)和TXNIP(OR=0.57,95%CI为0.36~0.89,P=0.014)是HCC患者TACE治疗后预后的独立保护因素。ROC曲线分析显示,治疗前血清SOCS3、TXNIP联合检测预测HCC患者TACE治疗预后的敏感性为81%,特异性为92%,曲线下面积为0.92(95%CI为0.85~0.96)。结论行TACE治疗HCC患者治疗前血清SOCS3、TXNIP水平低,可能提示TACE治疗后预后不良,二者联合检测对判断HCC患者TACE治疗的预后有一定预测价值。

Objective To investigate the prognostic value of serum suppressor of cytokine signaling 3(SOCS3)and thioredoxin-interacting protein(TXNIP)levels in transcatheter arterial chemoembolization(TACE)treatment of hepatocellular carcinoma(HCC).Methods A total of 107 HCC patients who underwent TACE treatment in Wuhan Hanyang Hospital from December 2019 to July 2021 were selected as the observation objects.According to the situation after TACE treatment,the patients were divided into poor prognosis group(n=47)and good prognosis group(n=60).Serum SOCS3 and TXNIP levels were detected by enzyme-linked immunosorbent assay,the prognostic factors were analyzed by logistic regression.The predictive value of serum SOCS3 and TXNIP levels before treatment for TACE treatment prognosis in patients with HCC was analyzed by receiver operator characteristic(ROC)curve.Results There were no statistically significant differences between good prognosis group and poor prognosis group in age(χ^(2)=0.56,P=0.453),gender(χ^(2)=0.06,P=0.800),tumor size(χ^(2)=1.46,P=0.227),Child-Pugh grade(χ^(2)=0.26,P=0.608),tumor number(χ^(2)=0.77,P=0.382),cirrhosis(χ^(2)=0.03,P=0.860),TACE times(χ^(2)=0.16,P=0.691),alpha-fetoprotein level before treatment(χ^(2)=0.79,P=0.374),and hepatitis B surface antigen(χ^(2)=0.58,P=0.446).The proportion of TNM stageⅢpatients in the poor prognosis group(57.45%,27/47)was higher than that in the good prognosis group(25.00%,15/60),with a statistically significant difference(χ^(2)=11.64,P=0.001).The serum levels of SOCS3 and TXNIP in the good prognosis group before treatment were(114.34±20.39)and(45.64±6.41)pg/ml,respectively,while those in the poor prognosis group were(82.83±15.97)and(34.82±6.36)pg/ml,respectively,serum SOCS3 and TXNIP levels in the poor prognosis group were lower than those in the good prognosis group,with statistically significant differences(t=8.71,P<0.001;t=8.70,P<0.001).After treatment,the serum SOCS3 and TXNIP levels in the good prognosis group were(139.65±24.32)and(64.75±7.58)pg/ml,respectively,while those in the poor prognosis group were(92.41±16.15)and(41.74±7.23)pg/ml,serum SOCS3 and TXNIP levels in the poor prognosis group were lower than those in the good prognosis group,with statistically significant differences(t=11.48,P<0.001;t=15.90,P<0.001).Serum SOCS3 and TXNIP levels in both groups were significantly higher after treatment than before(all P<0.05).Multivariate analysis showed that TNM stage(OR=2.53,95%CI:1.27-5.02,P=0.008)was an independent risk factor for prognosis in HCC patients after TACE treatment,SOCS3(OR=0.65,95%CI:0.44-0.96,P=0.031)and TXNIP(OR=0.57,95%CI:0.36-0.89,P=0.014)were independent protective factors for prognosis in HCC patients after TACE treatment.ROC curve analysis showed that the sensitivity and specificity of the combined detection of serum SOCS3 and TXNIP before treatment in predicting prognosis of TACE treatment in HCC patients were 81%and 92%,respectively,the area under the curve was 0.92(95%CI:0.85-0.96).Conclusion The low levels of serum SOCS3 and TXNIP before TACE treatment in HCC patients may indicate poor prognosis after TACE treatment.The combined detection of the two has certain predictive value for judging the prognosis of HCC patients after TACE treatment.