血清8-羟基脱氧鸟苷和连接蛋白4对原发性肝癌经导管肝动脉栓塞术后疗效的评估价值

The evaluation value of serum 8-OHdG and nectin-4 in the postoperative efficacy of transcatheter hepatic chemoembolization for primary liver cancer

目的探讨8-羟基脱氧鸟苷(8-OHdG)、连接蛋白4(nectin-4)在原发性肝癌血清中的表达以及对原发性肝癌经导管肝动脉栓塞(TACE)术后疗效的评估价值。方法2021年1月~2022年6月我院TACE治疗的原发性肝癌病人180例。根据TACE术后疗效分为良好组(137例)和不良组(43例)。比较两组一般临床资料和血清8-OHdG、nectin-4表达水平;多因素Logistic回归分析原发性肝癌TACE术后疗效的影响因素;ROC曲线分析血清8-OHdG、nectin-4水平对原发性肝癌TACE术后疗效的评估价值。结果两组年龄、性别、BMI、Child-Pugh分级、肿瘤位置、肿瘤数目、肿瘤直径、肿瘤轮廓、分化程度、肿瘤包膜、血管癌栓、胆管癌栓、淋巴结转移比较,差异无统计学意义(P>0.05)。不良组血清8-OHdG、nectin-4的表达水平高于良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血清8-OHdG、nectin-4、肿瘤直径、TNM分期及淋巴结转移均为TACE术后疗效的独立影响因素(P<0.05)。血清8-OHdG、nectin-4二者联合评估原发性肝癌TACE术后疗效的AUC为0.930,敏感性为86.05%,特异性为94.16%,优于各自单独评估(Z二者联合-8-OHdG=2.033、Z二者联合-nectin-4=3.221,P=0.042、0.001)。结论原发性肝癌TACE术后疗效不良组血清8-OHdG、nectin-4水平升高,二者联合对原发性肝癌TACE术后疗效有较好的评估效能。

Objective To investigate the expression of 8-hydroxy deoxyguanosine(8-OHdG)and nectin-4 in the serum of primary liver cancer(PLC),and to evaluate the efficacy of transcatheter chemoembolization(TACE)for PLC.Methods From January 2021 to June 2022,180 patients with primary liver cancer with TACE were studied.According to the efficacy of TACE patients,they were separated into a good group(n=137)and an adverse group(n=43).The general clinical data and the serum expression levels of 8-OHdG and nectin-4 were compared between the two groups;multivariate Logistic regression was applied to analyze the influencing factors of postoperative efficacy in TACE for primary liver cancer;receiver operating characteristic was applied to analyze the value of serum 8-OHdG and nectin-4 levels in evaluating the efficacy of TACE for primary liver cancer.Results There were no significant differences in age,sex,BMI,Child-Pugh grade,tumor location,tumor number,tumor diameter,tumor contour,degree of differentiation,tumor envelope,vascular cancer thrombus,bile duct cancer thrombus and lymph node metastasis between the poor postoperative efficacy group and the good efficacy group after TACE for primary liver cancer(P>0.05).The expression levels of serum 8-OHdG and nectin-4 in the poor postoperative efficacy group after TACE for primary liver cancer were obviously higher than those in the good efficacy group(P<0.05).Multivariate Logistic regression analysis showed that serum 8-OHdG,nectin-4,tumor diameter,TNM staging and Lymph node metastasis were all independent influencing factors for the postoperative efficacy of TACE in primary liver cancer(P<0.05).The AUC of the combined evaluation of serum 8-OHdG and nectin-4 for the postoperative efficacy of TACE in primary liver cancer was 0.930,with a sensitivity of 86.05%and a specificity of 94.16%,which was superior to their respective individual evaluations(Z combination-8-OHdG=2.033,Z combination-nectin-4=3.221,P=0.042,0.001).Conclusion The serum levels of 8-OHdG and nectin-4 are obviously increased in the poor postoperative efficacy group after TACE for primary liver cancer.The combination of the two has a good evaluation effect on the postoperative efficacy of TACE for primary liver cancer.