血清HOXC9在肝细胞癌患者中的表达及其对预后的评估价值

Expression of serum HOXC9 in patients with hepatocellular carcinoma and its prognostic value

目的探讨血清同源盒基因C9(HOXC9)在肝细胞癌(HCC)患者中的表达及其对预后的评估价值。方法选取2020年3月至2021年2月于南京医科大学康达学院附属连云港东方医院就诊的79例HCC患者(HCC组)和72例良性肝病患者(良性肝病组)作为研究对象。另选取同期在该院75例体检健康者作为健康对照组。采用酶联免疫吸附试验法对血清HOXC9水平进行检测,采用化学发光法对血清甲胎蛋白(AFP)水平进行检测。分析血清HOXC9水平与HCC患者临床病理特征的关系,并采用Kaplan-Meier生存曲线分析血清HOXC9水平与HCC预后的关系,绘制受试者工作特征曲线分析其诊断效能。结果HCC组HOXC9和AFP水平明显高于良性肝病组和健康对照组,差异有统计学意义(P<0.05)。HOXC9阳性组与肿瘤分化程度、TNM分期、血管浸润和淋巴结转移有关(χ^(2)=4.521、3.526、2.758、3.787,均P<0.05)。HOXC9阳性组患者3年生存率为64.71%(44/68),阴性组患者3年生存率为81.82%(9/11)。Kaplan-Meier生存曲线分析显示,HOXC9阳性组患者3年生存率低于HOXC9阴性组,HOXC9阳性组患者预后更差,差异有统计学意义(χ^(2)=5.367,P<0.05)。Cox多因素分析结果显示:病灶个数多发、有血管浸润、TNM分期Ⅲ~Ⅳ期和HOXC9≥100 mAU/mL是影响HCC患者预后不良的独立危险因素。HOXC9和AFP联合检测的曲线下面积为0.946(95%CI:0.876~0.979),显著高于单项检测,差异均有统计学意义(Z=0.871、0.511,P<0.05)。结论血清HOXC9水平检测有助于评估HCC患者预后,可作为HCC患者预后判断的生物标志物。

Objective To investigate the expression of serum homeobox C9(HOXC9)in patients with hepatocellular carcinoma(HCC)and its prognostic value.Methods A total of 79 patients with HCC(HCC group)and 72 patients with benign liver disease(benign liver disease group)were selected as the study objects from the Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University from March 2020 to February 2021.Another 75 healthy subjects in the same period were selected in a hospital as healthy control group.The serum HOXC9 level was detected by enzyme-linked immunosorbent assay and the serum alpha-fetoprotein(AFP)level was detected by chemiluminescence assay.The relationship between serum HOXC9 level and clinicopathological features of HCC patients was analyzed,and Kaplan-Meier survival curve was used to analyze the relationship between serum HOXC9 level and HCC prognosis,and the receiver operating characteristic curve was drawn to analyze the diagnostic efficacy.Results The levels of HOXC9 and AFP in HCC group were significantly higher than those in benign liver disease group and healthy control group,and the difference was statistically significant(P<0.05).HOXC9 positive group was correlated with tumor differentiation,TNM stage,vascular invasion and lymph node metastasis(χ^(2)=4.521,3.526,2.758,3.787,all P<0.05).The 3-year survival rate was 64.71%(44/68)in the HOXC9 positive group and 81.82%(9/11)in the HOXC9 negative group.Kaplan-Meier survival curve analysis showed that the 3-year survival rate of HOXC9 positive group was lower than that of HOXC9 negative group,and the prognosis of HOXC9 positive group was worse,the difference was statistically significant(χ^(2)=5.367,P<0.05).Cox multivariate analysis showed that multiple lesions,vascular infiltration,TNM stageⅢ-Ⅳstage and HOXC9≥100 mAU/mL were independent risk factors for poor prognosis in HCC patients.The area under the curve of HOXC9 and AFP combined detection was 0.946(95%CI:0.876—0.979),which was significantly higher than that of single detection,and the differences were statistically significant(Z=0.871,0.511,P<0.05).Conclusion The detection of serum HOXC9 level is helpful to evaluate the prognosis of HCC patients,and can be used as a biomarker for the prognosis of HCC patients.