摘要
目的 分析血清乙型肝炎病毒大蛋白(HBV-LP)和干扰素诱导型双链RNA依赖性蛋白激酶激活剂A(PRKRA)水平对乙型肝炎病毒相关原发性肝癌(HBV-PLC)术后复发风险评估的价值.方法 收集确诊为HBV-PLC病人105例,根据术后是否复发分为未复发组(38例)和复发组(67例).比较两组病人临床基线资料、生化指标结果和病理资料;采用ELISA法检测病人血清HBV-LP和PRKRA水平;采用Pearson相关性分析血清HBV-LP和PRKRA的关系,Cox回归模型分析HBV-PLC术后复发的危险因素;绘制受试者工作特征(ROC)曲线,分析HBV-LP联合PRKRA检测对HBV-PLC术后复发风险的预测价值.结果 两组病人性别、年龄、吸烟史、饮酒量、血清生化指标和肝硬化等差异无统计学意义(P＞0.05),两组甲胎蛋白(AFP)＜25 μg/L、肿瘤大小、肿瘤包膜、肝转移、血管侵袭和肿瘤分化程度差异有统计学意义(x2=4.217～10.849,P＜0.05).与未复发组比较,复发组病人血清HBV-LP和PRKRA水平明显升高(t=6.501、3.615,P＜0.01).HBV-PLC病人血清HBV-LP与PRKRA水平呈正相关(r=0.839,P＜0.01).肿瘤直径(2～5 cm)、肿瘤包膜、肿瘤低分化、血清HBV-LP和PRKRA是HBV-PLC术后复发的危险因素(HR=1.083～6.938,P＜0.05).ROC曲线分析显示,血清HBV-LP和PRKRA水平及二者联合对HBV-PLC病人术后复发有预测价值,ROC曲线下面积分别为0.796、0.685、0.822.结论 血清HBV-LP和PRKRA水平升高是HBV-PLC病人术后复发的独立危险因素,二者联合检测对HBV-PLC病人术后复发具有良好的预测价值.
Abstract
Objective To investigate the value of the serum levels of hepatitis B virus large protein(HBV-LP)and interfe-ron-inducible double-stranded RNA-dependent protein kinase activator A(PRKRA)in predicting the risk of postoperative recur-rence of hepatitis B virus-related primary liver cancer(HBV-PLC).Methods A totalof 105 patients who were diagnosed with HBV-PLC were enrolled,and according to the presence or absence of recurrence after surgery,they were divided into non-recur-rence group with 38 patients and recurrence group with 67 patients.The two groups were compared in terms of clinical baseline da-ta,biochemical parameters,and pathological data.ELISA was used to measure the serum levels of HBV-LP and PRKRA;a Pear-son correlation analysis was used to investigate the correlation between serum HBV-LP and PRKRA,and the Cox regression model was used to analyze the risk factors for postoperative recurrence of HBV-PLC.The receiver operating characteristic(ROC)curve wasplotted to assess the value of HBV-LP combined with PRKRA in predicting the risk of postoperative recurrence of HBV-PLC.Results There were no significant differences between the two groups in sex,age,smoking history,alcohol consumption,serum biochemical parameters,and liver cirrhosis(P＞0.05),while there were significant differences between the two groups in alpha-fe-toprotein＜25 μg/L,tumor size,presence of capsule,liver metastasis,vascular invasion,and degree of tumor differentiation(x2=4.217-10.849,P＜0.05).Compared with the non-recurrence group,the recurrence group had significant increases in the serum levels of HBV-LP and PRKRA(t=6.501,3.615;P＜0.01).There was a positive correlation between serum HBV-LP and PRKRA in HBV-PLC patients(r=0.839,P＜0.01).Tumor diameter(2-5 cm),tumor encapsulation,poor tumor differentiation,and elevated serum levels of HBV-LP and PRKRA were risk factors for postoperative recurrence of HBV-PLC(HR=1.083-6.938,P＜0.05).The ROC curve analysis showed that the serum levels of HBV-LP and PRKRA used alone or in combination had a certain value in predicting postoperative recurrence in HBV-PLC patients,with an area under the ROC curve of 0.796,0.685,and 0.822,respectively.Conclusion Elevated serum levels of HBV-LP and PRKRA are independent risk factors for postoperative recurrence in HBV-PLC patients,and the combined measurement of serum HBV-LP and PRKRA has a good predictive value for postoperative recurrence in HBV-PLC patients.
基金项目
贵州省卫生计生委科学技术基金项目(gzwjkj2018-1-088)
维普
万方数据