GP73与铁调素在HBV相关性肝癌患者血清中表达变化及与预后的相关性

摘要/Abstract

摘要： 目的探讨高尔基体蛋白73(GP73)与铁调素(Hepc)在HBV相关性肝癌患者血清中表达变化及与预后的相关性。方法收集2017年9月至2018年9月四川省宜宾市第二人民医院收治的HBV相关性肝癌患者98例,记为研究组。选择同期在本院体检的健康者92例,记为对照组。对比两组血清GP73和Hepc水平,对比乙肝相关性肝癌死亡与生存患者血清GP73和Hepc水平,采用Logistic回归分析影响乙肝相关性肝癌患者死亡的危险因素。采用受试者操作特征曲线(ROC)分析血清GP73和Hepc水平预测乙肝相关性肝癌患者死亡的效能。结果研究组血清GP73、Hepc水平分别为[(204.7±10.3)ng/mL、(128.3±12.6)μg/L],均高于对照组[(38.1±6.7)ng/mL、(77.9±9.5)μg/L],差异具有统计学意义(P<0.05);随访2年,乙肝相关性肝癌患者死亡率为28.4%;死亡患者血清GP73、Hepc水平分别为[(261.6±12.7)ng/mL、(165.8±13.2)μg/L],均高于生存患者[(182.5±5.9)ng/mL、(113.1±10.4)μg/L],差异具有统计学意义(P<0.05);Logistic多因素分析显示,TNM分期Ⅲ~Ⅳ期、GP73、Hepc均是影响乙肝相关性肝癌患者死亡的独立危险因素(OR=2.570、1.984、2.121,P均<0.05)。ROC分析显示,血清GP73和Hepc水平预测乙肝相关性肝癌患者死亡的最佳截断值分别为25.3 ng/mL、130.0 μg/L,灵敏度分别为70.4%、88.9%,特异度分别为89.7%、72.1%,曲线下面积(AUC)分别为0.887(95%CI:0.805~0.943)和0.883(95%CI:0.801~0.940)。结论乙肝相关性肝癌患者血清GP73、Hepc水平异常升高,且TNM分期Ⅲ~Ⅳ期、GP73、Hepc均是影响HBV相关性肝癌患者死亡的独立危险因素。

关键词: HBV相关性肝癌, 高尔基体蛋白73, 铁调素, 预后

Abstract: Objective To explore the changes of Golgi protein 73 (GP73) and hepcidin (Hepc) levels in the serum of hepatitis B-related liver cancer patients and their correlation with the patients’ prognosis. Methods Ninety-eight patients with hepatitis B-related liver cancer admitted between September 2017 to September 2018 were enrolled in this study as the research group. Ninety-two healthy examined people during the same time period were collected as the control group. Serum GP73 and Hepc levels were compared between the research and the control groups, and between the death and survival patients with hepatitis B-related liver cancer. Logistic regression analysis was performed to identify the risk factors affecting the patients’ survival. Receiver operating characteristic curve (ROC) was drawn for analyzing the efficacy of serum GP73 and Hepc levels in predicting the prognosis of patients with hepatitis B-related liver cancer. Results Serum GP73 and Hepc levels in the study group were (204.7±10.3) ng/mL and (128.3±12.6) μg/L, respectively, which were significantly higher than those in the control group [(38.1±6.7) ng/mL and (77.9±9.5) μg/ L, respectively] (P<0.05). After 2 years of follow-up, the mortality of patients with hepatitis B-related liver cancer was 28.4%. The serum GP73 and Hepc levels of dead patients were (261.6±12.7) ng/mL and (165.8±13.2) μg/L,respectively, which were significantly higher than those of surviving patients [(182.5±5.9) ng/mL and (113.1±10.4) μg/L, respectively] (P<0.05). Logistic multivariate analysis showed that TNM stage III-IV, high serum levels of GP73 and Hepc were all independent risk factors affecting the survival of patients with hepatitis B-related liver cancer (OR=2.570, 1.984, 2.121, all P<0.05). ROC analysis showed that the best cut-off points of serum GP73 and Hepc levels for predicting death of hepatitis B-related liver cancer patients were 25.3 ng/mL and 130.0 μg/L, respectively. The sensitivity were 70.4%, 88.9%, and the specificity were 89.7%, 72.1%, respectively. The area under the curve (AUC) were 0.887 (95%CI: 0.805~0.943) and 0.883 (95%CI: 0.801~0.940). Conclusion Serum GP73 and Hepc levels in patients with hepatitis B-related liver cancer are abnormally elevated. TNM stages III to IV, high levels of GP73 and Hepc are independent risk factors that affect the survival of patients with hepatitis B-related liver cancer.

Key words: Hepatitis B related liver cancer, Hepatitis B, Golgi protein 73, Hepcidin, Prognosis

陈超, 姚玲, 邱邦东, 王小燕. GP73与铁调素在HBV相关性肝癌患者血清中表达变化及与预后的相关性[J]. 肝脏, 2021, 26(9): 1007-1010.

CHEN Chao, YAO Ling, QIU Bang-dong, WANG Xiao-yan. Serum GP73 and hepcidin levels are corelated with the prognosis of hepatitis B-related liver cancer patients[J]. Chinese Hepatolgy, 2021, 26(9): 1007-1010.

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