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)<25μg/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(χ^(2)=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。
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 recurrence 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-recurrence group with 38 patients and recurrence group with 67 patients.The two groups were compared in terms of clinical baseline data,biochemical parameters,and pathological data.ELISA was used to measure the serum levels of HBV-LP and PRKRA;a Pearson 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-fetoprotein<25μg/L,tumor size,presence of capsule,liver metastasis,vascular invasion,and degree of tumor differentiation(χ^(2)=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.
作者
蒋石艳
左丽
陈美利
黄河龙
简雪瑶
JIANG Shiyan;ZUO Li;CHEN Meili;HUANG Helong;JIAN Xueyao(Department of Immunology,School of Basic Medicine,Guizhou Medical University,Guiyang 550000,China)
出处
《青岛大学学报（医学版）》
CAS
2024年第3期407-411,共5页
Journal of Qingdao University(Medical Sciences)
基金
贵州省卫生计生委科学技术基金项目(gzwjkj2018-1-088)。
关键词
乙型肝炎病毒
干扰素诱导的双链RNA依赖激活剂
肝肿瘤
肿瘤复发
局部
hepatitis B virus
interferon-inducible double stranded RNA-dependent protein kinase activator A
liver neoplasms
neoplasm recurrence,local
