Effect of expression of serum hypoxia inducible factor-1α and alpha fetoprotein on prognosis of transhepatic arterial chemoembolization in patients with liver cancer
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摘要:目的
分析血清低氧诱导因子-1α(HIF-1α)、甲胎蛋白(AFP)表达对肝癌患者肝动脉化疗栓塞术(TACE)治疗预后的影响。
方法选取2019年1月—2021年12月行TACE治疗的80例肝癌患者作为研究对象, 3周为1个治疗周期，均治疗2个周期。患者均接受至少1个月随访，依据患者疾病缓解情况评估其预后，并分为不良组(n=34)与良好组(n=46)。比较2组基线资料，分析治疗前血清HIF-1α、AFP表达对肝癌患者TACE预后的影响。
结果随访1个月时，预后不良34例，占比42.50%。不良组血清AFP、HIF-1α水平高于良好组，差异有统计学意义(P < 0.05); 治疗前血清AFP、HIF-1α高表达可能是肝癌患者TACE治疗预后不良的风险因子(OR>1, P < 0.05); 受试者工作特征(ROC)曲线结果显示，治疗前血清AFP、HIF-1α水平预测肝癌患者TACE治疗预后不良风险的曲线下面积(AUC)均>0.70, 预测价值较为理想，且以联合预测价值最高。
结论肝癌患者治疗前血清AFP、HIF-1α的异常高表达对TACE治疗预后不良有一定的影响。
Abstract:ObjectiveTo analyze the influence of the expression of serum hypoxia inducible factor-1α (HIF-1α) and alpha fetoprotein (AFP) on the prognosis of transhepatic arterial chemoembolization (TACE) in patients with liver cancer.
MethodsA total of 80 patients with liver cancer treated by TACE from January 2019 to December 2021 were selected as research subjects, 3 weeks was a treatment cycle, all of them were treated for 2 cycles. All patients were followed up for at least 1 month, and their prognosis was evaluated according to their disease remission, and they were divided into poor group (n=34) and good group (n=46). The baseline data of the two groups were compared, and the effects of serum HIF-1α and AFP expression before treatment on the prognosis of liver cancer patients with TACE were analyzed.
ResultsAt 1 month of followed up, 34 cases had poor prognosis, accounting for 42.50%; the levels of serum AFP and HIF-1α in the poor group were significantly higher than those in the good group (P < 0.05); high levels of serum AFP and HIF-1α before treatment might be risk factors for poor prognosis in patients with liver cancer after TACE treatment (OR>1, P < 0.05); the results of receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of serum AFP and HIF-1α levels before treatment in predicting the risk of poor prognosis in patients with liver cancer after TACE treatment were above 0.70, and the predictive value was ideal, and the combined predictive value was the highest.
ConclusionThe abnormal high expression of serum AFP and HIF-1α in patients with liver cancer before treatment has a certain effect on the poor prognosis of TACE treatment.
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表 1 不良组与良好组基线资料比较(x±s)[n(%)]
资料 分类 不良组(n=34) 良好组(n=46) χ2/t P 性别 男 25(73.53) 35(76.09) 0.068 0.794 女 9(26.47) 11(23.91) 年龄/岁 56.35±5.13 55.84±5.09 0.442 0.660 Child分级 A级 20(58.82) 29(63.04) 0.147 0.702 B级 14(41.18) 17(36.96) 肿瘤数目 单发 18(52.94) 27(58.70) 0.263 0.608 多发 16(47.06) 19(41.30) 最大肿瘤直径/cm 5.08±1.04 4.87±1.10 0.831 0.408 肝硬化病史 有 11(32.35) 16(34.78) 0.052 0.821 无 23(67.65) 30(65.22) 肿瘤部位 左半肝 9(26.47) 12(26.09) 0.369 0.832 右半肝 15(44.12) 23(50.00) 左、右半肝 10(29.41) 11(23.91) 谷草转氨酶/(U/L) 46.35±4.81 45.97±5.27 0.331 0.742 谷丙转氨酶/(U/L) 42.35±5.08 41.37±6.40 0.737 0.463 总胆红素/(μmol/L) 21.09±3.37 20.89±3.40 0.261 0.795 甲胎蛋白/(ng/mL) 582.30±138.47 345.35±65.73 10.174 < 0.001 低氧诱导因子-1α/(pg/mL) 688.35±152.31 565.26±140.47 3.738 < 0.001 
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表 2 肝癌患者TACE治疗预后影响因素Logistic回归分析
指标 B SE WaId P OR 95%CI 常量 -13.336 3.227 17.076 < 0.001 — — 甲胎蛋白 0.022 0.005 16.501 < 0.001 1.022 1.011~1.033 低氧诱导因子-1α 0.006 0.003 3.978 0.046 1.006 1.000~1.011
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表 3 血清AFP、HIF-1α水平预测肝癌患者TACE治疗预后不良风险
变量 AUC cut-off值/(ng/mL) 95%CI P 特异度 灵敏度 约登指数 AFP 0.795 430.205 0.688~0.902 < 0.001 0.804 0.735 0.539 HIF-1α 0.751 618.635 0.644~0.858 < 0.001 0.696 0.765 0.461 联合 0.855 — 0.772~0.938 < 0.001 0.826 0.765 0.591
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[1] 李英锋, 蒋寒, 尹同治. TACE对肝癌患者术后疗效及预后的影响因素分析[J]. 中国现代普通外科进展, 2017, 20(6): 447-450. https://www.cnki.com.cn/Article/CJFDTOTAL-PWJZ201706007.htm [2] 李佳, 曾宝珠, 孙志刚. 动脉置管灌注华蟾素注射液联合TACE术对原发性肝癌患者HIF-1α、VEGF的影响及其机理探讨[J]. 世界中医药, 2018, 13(2): 396-399. doi: 10.3969/j.issn.1673-7202.2018.02.037 [3] NING X, WANG Y, YAN W, et al. Chitin synthesis inhibitors promote liver cancer cell metastasis via interfering with hypoxia-inducible factor 1α[J]. Chemosphere, 2018, 206: 231-237. doi: 10.1016/j.chemosphere.2018.05.014
[4] 魏容, 梁艳丽, 王明霞, 等. 原发性肝癌患者治疗后血清AFP、NLR、PLT及部分凝血指标的变化[J]. 贵州医科大学学报, 2017, 42(11): 1297-1301. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYB201711013.htm [5] 邱志琦, 王欣悦. PIVKA-Ⅱ、AFP在原发性肝癌诊断中的应用价值[J]. 检验医学与临床, 2018, 15(22): 3377-3379. doi: 10.3969/j.issn.1672-9455.2018.22.015 [6] 中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017年版)[J]. 中华肝脏病杂志, 2017, 25(12): 886-895. doi: 10.3760/cma.j.issn.1007-3418.2017.12.002 [7] NAKAGAWA S, HAYASHI H, NITTA H, et al. Scoring system based on tumor markers and Child-Pugh classification for HCC patients who underwent liver resection[J]. Anticancer Res, 2015, 35(4): 2157-2163.
[8] DE KOCK I, MIRHOSSEINI M, LAU F, et al. Conversion of karnofsky performance status (KPS) and eastern cooperative oncology group performance status (ECOG) to palliative performance scale (PPS), and the interchangeability of PPS and KPS in prognostic tools[J]. J Palliat Care, 2013, 29(3): 163-169. doi: 10.1177/082585971302900305
[9] 鲍云华, 李俭杰. 介绍新的实体瘤治疗反应评价标准(RECIST)[J]. 中国肺癌杂志, 2005, 8(1): 77-78. doi: 10.3779/j.issn.1009-3419.2005.01.21 [10] 沈建东, 戴锋, 王晓维, 等. 异常凝血酶原(PIVKA-Ⅱ)对TACE治疗肝癌疗效预测[J]. 介入放射学杂志, 2020, 29(1): 75-78. doi: 10.3969/j.issn.1008-794X.2020.01.015 [11] 冷俊, 秦兵. 血清4项肿瘤标志物联合检测诊断原发性肝癌的价值[J]. 实用临床医药杂志, 2020, 24(15): 18-20, 31. doi: 10.7619/jcmp.202015005 [12] TAJUL ARIFIN K, SULAIMAN S, MD SAAD S, et al. Elevation of tumour markers TGF-β, M2-PK, OV-6 and AFP in hepatocellular carcinoma (HCC)-induced rats and their suppression by microalgae Chlorella vulgaris[J]. BMC Cancer, 2017, 17(1): 879. doi: 10.1186/s12885-017-3883-3
[13] TZARTZEVA K, SINGAL A G. Testing for AFP in combination with ultrasound improves early liver cancer detection[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(10): 947-949. doi: 10.1080/17474124.2018.1512855
[14] FU C Y, AN N, LIU J M, et al. The transcription factor ZFHX3 is crucial for the angiogenic function of hypoxia-inducible factor 1α in liver cancer cells[J]. J Biol Chem, 2020, 295(20): 7060-7074. doi: 10.1074/jbc.RA119.012131
[15] 李燕京, 张泳, 许永攀, 等. 甲胎蛋白异质体在原发性肝癌患者血清中的表达[J]. 基因组学与应用生物学, 2019, 38(8): 3765-3770. https://www.cnki.com.cn/Article/CJFDTOTAL-GXNB201908053.htm [16] BENEDUCE L, CASTALDI F, MARINO M, et al. Improvement of liver cancer detection with simultaneous assessment of circulating levels of free alpha-fetoprotein (AFP) and AFP-IgM complexes[J]. Int J Biol Markers, 2004, 19(2): 155-159. doi: 10.1177/172460080401900211
[17] 刘永炜, 吴向民. 血清AFP、CA199和CEA水平在肝癌诊断和预后中的作用[J]. 检验医学, 2017, 32(5): 406-409. doi: 10.3969/j.issn.1673-8640.2017.05.014 [18] YE Y B, PENG Y R, LI Y S, et al. Effect of lincRNA-p21 targeting HIF-1α on biological functions of liver cancer cells[J]. Oncol Lett, 2019, 17(6): 4964-4968.
[19] ZHANG G, FENG G Y, GUO Y R, et al. Correlation between liver cancer pain and the HIF-1 and VEGF expression levels[J]. Oncol Lett, 2017, 13(1): 77-80.
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