肝细胞癌患者血清PTPN3、VEGF、IRX5、HOTAIR的表达水平及其与病理特征和预后的相关性

Expression levels of serum PTPN3,VEGF,IRX5,and HOTAIR in patients with hepatocellular carcinoma and their correlation with pathological characteristics and prognosis

目的检测血清蛋白质酪氨酸磷酸酶3(PTPN3)、血管内皮生长因子(VEGF)、易洛魁族同源盒基因5(IRX5)、长链非编码RNA HOX转录反义RNA(HOTAIR)在肝细胞癌(HCC)中的表达水平,并分析其与患者的病理特征和预后的相关性,为临床工作提供血清学参考。方法选取2020年6月至2022年10月南阳市中心医院收治的117例HCC患者作为观察组,另选取同期117例良性肝内结节患者作为对照组,比较两组患者的血清PTPN3、VEGF、IRX5、HOTAIR水平,分析HCC患者血清PTPN3、VEGF、IRX5、HOTAIR水平与病理特征的关系。随访6个月,依据患者预后情况分为预后良好组72例和预后不良组45例,比较不同预后患者的血清PTPN3、VEGF、IRX5、HOTAIR水平,采用受试者工作特征(ROC)曲线分析血清PTPN3、VEGF、IRX5、HOTAIR单独及联合预测HCC预后的效能,采用相对危险度(RR)分析血清PTPN3、VEGF、IRX5、HOTAIR水平与HCC预后的关系。结果观察组患者的血清PTPN3、VEGF、IRX5、HOTAIR水平分别为(181.42±10.19)ng/mL、(154.66±11.82)μmol/L、(82.42±8.23)ng/mL、1.20±0.28,明显高于对照组的(86.64±13.28)ng/m L、(83.64±9.50)μmol/L、(34.80±6.63)ng/m L、1.07±0.25,差异均有统计学意义(P<0.05);不同TNM分期、分化程度、肿瘤直径、伴肝硬化、区域淋巴结转移、Ki-67指数、脉管内瘤栓、包膜侵犯HCC患者血清PTPN3、VEGF、IRX5、HOTAIR水平比较,差异均有统计学意义(P<0.05);肿瘤多发患者的血清VEGF水平为(154.10±10.26)μmol/L,明显高于肿瘤单发患者的(191.62±9.45)μmol/L,差异有统计学意义(P<0.05);治疗后2个月,预后良好患者的血清PTPN3、VEGF、IRX5、HOTAIR水平分别为(153.69±22.24)ng/m L、(113.27±25.64)μmol/L、(70.53±10.24)ng/m L、1.15±0.23,明显低于预后不良患者的(217.58±27.06)ng/m L、(215.33±38.19)μmol/L、(96.35±14.88)ng/m L、1.36±0.28,差异均有统计学意义(P<0.05);绘制血清PTPN3、VEGF、IRX5、HOTAIR单独及联合预测HCC预后的ROC,结果显示各血清联合预测的AUC最大,为0.924(95%CI:0.860~0.965);HCC预后不良的危险度分析结果显示,血清PTPN3、VEGF、IRX5、HOTAIR所致RR值分别为4.604(95%CI:2.602~8.145)、7.139(95%CI:3.660~13.924)、4.733(95%CI:2.749~8.149)、4.690(95%CI:2.575~8.544)(P<0.05)。结论血清PTPN3、VEGF、IRX5、HOTAIR在HCC中的表达异常升高,且与病理特征联系密切,对患者预后有一定评估作用。

Objective To detect the expression levels of serum protein tyrosine phosphatase 3(PTPN3),vascu-lar endothelial growth factor(VEGF),Iroquois homeobox gene 5(IRX5),and long non-coding RNA HOX antisense RNA(HOTAIR)in hepatocellular carcinoma(HCC),and analyze their correlation with patients’pathological character-istics and prognosis,in order to provide a serological reference for clinical work.Methods A total of 117 patients with HCC admitted to Nanyang Central Hospital from June 2020 to October 2022 were selected as the observation group,and another 117 patients with benign intrahepatic nodules in the same period were selected as the control group.The levels of serum PTPN3,VEGF,IRX5,and HOTAIR in the two groups were compared,and the relationship between the levels of serum PTPN3,VEGF,IRX5,and HOTAIR in HCC patients and their pathological characteristics was analyzed.After a follow-up of 6 months,patients were divided into a good prognosis group(72 cases)and a poor prognosis group(45 cases)according to their prognosis.The levels of serum PTPN3,VEGF,IRX5,and HOTAIR between patients with different prognoses were compared.The performance of serum PTPN3,VEGF,IRX5,HOTAIR,and their combination for predicting HCC prognosis was analyzed using the receiver operating characteristic(ROC)curve.The relationship be-tween the levels of serum PTPN3,VEGF,IRX5,HOTAIR and the prognosis of HCC was analyzed using relative risk(RR).Results The serum levels of PTPN3,VEGF,IRX5,and HOTAIR in the observation group were(181.42±10.19)ng/mL,(154.66±11.82)μmol/L,(82.42±8.23)ng/mL,and 1.20±0.28,respectively,which were signifi-cantly higher than(86.64±13.28)ng/mL,(83.64±9.50)μmol/L,(34.80±6.63)ng/mL,and 1.07±0.25 in the control group(P<0.05).The serum levels of PTPN3,VEGF,IRX5,and HOTAIR showed statistically significant differences among HCC patients with different TNM stages,differentiation degrees,tumor diameters,with cirrhosis,regional lymph node metastasis,Ki-67 index,intravascular tumor thrombus,and capsule invasion(P<0.05).The serum level of VEGF in patients with multiple tumors was(154.10±10.26)μmol/L,which was significantly higher than(191.62±9.45)μmol/L in patients with single tumor(P<0.05).The levels of serum PTPN3,VEGF,IRX5,and HOTAIR in patients with good prognosis after 2 months of treatment were(153.69±22.24)ng/mL,(113.27±25.64)μmol/L,(70.53±10.24)ng/mL,and 1.15±0.23,respectively,which were significantly lower than(217.58±27.06)ng/mL,(215.33±38.19)μmol/L,(96.35±14.88)ng/mL,and 1.36±0.28 in patients with poor prognosis(P<0.05).The AUC of the combination of serum PTPN3,VEGF,IRX5,HOTAIR for predicting HCC prognosis was the highest,which was 0.924(95%CI:0.860-0.965).The risk analysis of poor prognosis in HCC showed that the RR values caused by serum PTPN3,VEGF,IRX5,and HOTAIR were 4.604(95%CI:2.602-8.145),7.139(95%CI:3.660-13.924),4.733(95%CI:2.749-8.149),and 4.690(95%CI:2.575-8.544),respectively(P<0.05).Conclusion The expression of serum PTPN3,VEGF,IRX5,and HOTAIR is ab-normally elevated in HCC,which is closely related to pathological features and has a certain role in evaluating the prog-nosis of patients.