血清肿瘤异常蛋白、平均血小板体积/淋巴细胞比值与腹腔镜肝癌切除术患者预后的关系

肝脏 ›› 2024, Vol. 29 ›› Issue (12): 1489-1492.

血清肿瘤异常蛋白、平均血小板体积/淋巴细胞比值与腹腔镜肝癌切除术患者预后的关系

张贝克, 范永刚, 张莹楠, 姚国良

471003 洛阳河南科技大学第一附属医院肝胆胰外科(张贝克,范永刚,姚国良),小儿外科(张莹楠)

收稿日期:2024-02-19 出版日期:2024-12-31 发布日期:2025-02-19
通讯作者: 范永刚,Email:13881394@qq.com
基金资助:
河南省医学科技攻关计划项目(222102310221)

The relationship between serum tumor abnormal protein and mean platelet volume/lymphocyte ratio and the prognosis of patients with primary liver cancer undergoing laparoscopic hepatectomy

ZHANG Bei-ke¹, FAN Yong-gang¹, ZHANG Ying-nan², YAO Guo-liang¹

1. Department of Hepatobiliary Pancreatic Surgery, the First Affiliated Hospital of Henan University of Science & Technology, Luoyang 4710032, China;
2. Department of Pediatric Surgery, the First Affiliated Hospital of Henan University of Science & Technology, Luoyang 4710032, China

Received:2024-02-19 Online:2024-12-31 Published:2025-02-19
Contact: FAN Yong-gang,Email:13881394@qq.com

摘要/Abstract

摘要： 目的探究血清肿瘤异常蛋白(TAP)、平均血小板体积/淋巴细胞比值(MPVLR)与腹腔镜肝癌切除术患者预后的关系。方法选取2020年1月至2022年9月河南科技大学第一附属医院诊治的肝癌患者85例,均接受腹腔镜肝癌切除术治疗。术前检测患者TAP、MPVLR水平。术后随访1年,观察患者术后肿瘤复发、转移以及死亡发生情况,并将其分为预后不良组和预后良好组。单因素和多因素logistic回归分析腹腔镜肝癌切除术患者预后的影响因素,应用受试者工作特征曲线下面积(AUC)评估血清TAP、MPVLR对患者预后的评估效能。结果腹腔镜肝癌切除术患者预后不良发生率为27.06%(23/85)。预后不良组肿瘤直径≥3 cm占比、CNLC分期为Ⅲa期占比、肿瘤数量多发占比、TAP、MPVLR水平分别为73.9%、60.9%、65.2%、(187.8±37.5)μm²、(7.7±1.93),均高于预后良好组的37.1%、27.4%、32.3%、(139.2±27.8)μm²、(4.1±1.1),差异均有统计学意义(P<0.05)。多因素分析结果显示,CNLC分期(OR=6.62)、TAP(OR=5.39)、MPVLR(OR=3.85)是患者预后的独立危险因素(P<0.05)。ROC曲线显示,TAP、MPVLR及二者联合评估腹腔镜肝癌切除术患者预后的敏感度分别为0.78、0.74、0.87,特异度分别为0.76、0.74、0.92,AUC分别为0.82、0.80、0.91。结论血清TAP、MPVLR是腹腔镜肝癌切除术患者预后不良的独立危险因素,TAP联合MPVLR评估患者预后的效能较好。

关键词: 原发性肝癌, 腹腔镜肝癌切除术, 肿瘤异常蛋白, 平均血小板体积/淋巴细胞比值, 预后评估

Abstract: Objective To explore the relationship between serum tumor abnormal protein (TAP), mean platelet volume/lymphocyte ratio (MPVLR) and prognosis of patients with primary liver cancer (PLC) after laparoscopic hepatectomy.Methods Eight-five patients with PLC were enrolled in our hospital between January 2020 and September 2022. All patients underwent laparoscopic hepatectomy. The levels of TAP and MPVLR were detected before operation. The patients were followed up for 1 year after surgery to observe tumor recurrence, metastasis and death, and were divided into a poor prognosis group and a good prognosis group. Univariate and multivariate binary Logistic regression methods were used to analyze the influencing factors of prognosis in patients with PLC undergoing laparoscopic hepatectomy. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive efficacy of serum TAP and MPVLR for the prognosis of patients.Results The incidence of poor prognosis in patients with PLC undergoing laparoscopic hepatectomy was 27.06% (23/85). The proportion of tumor diameter ≥3 cm, the proportion of CNLC stage Ⅲa, the proportion of multiple tumor numbers, TAP and MPVLR levels were 73.9%, 60.9%, 65.2%, (187.8±37.5) μm², and (7.7±1.93) in the poor prognosis group, respectively, which were higher than those of 37.1%, 27.4%, 32.3%, (139.2±27.8) μm², and (4.1±1.1) in the good prognosis group (P<0.05). Multivariate analysis showed that CNLC stage (OR=6.62), TAP (OR=5.39) and MPVLR (OR=3.85) were independent risk factors for the patients' prognosis (P<0.05). ROC curve analysis showed that the sensitivity, specificity and AUC of TAP, MPVLR and their combination in evaluating the prognosis of patients with PLC undergoing laparoscopic hepatectomy were 0.78, 0.74 and 0.87, 0.76, 0.74 and 0.92, 0.82, 0.80 and 0.91, respectively.Conclusion Serum TAP and MPVLR are independent risk factors for poor prognosis in patients with PLC undergoing laparoscopic hepatectomy. TAP combined with MPVLR has a better efficacy in evaluating the patients' prognosis.

Key words: Primary liver cancer, Laparoscopic hepatectomy, Tumor abnormal protein, Mean platelet volume/lymphocyte ratio, Assessment of prognosis

张贝克, 范永刚, 张莹楠, 姚国良. 血清肿瘤异常蛋白、平均血小板体积/淋巴细胞比值与腹腔镜肝癌切除术患者预后的关系[J]. 肝脏, 2024, 29(12): 1489-1492.

ZHANG Bei-ke, FAN Yong-gang, ZHANG Ying-nan, YAO Guo-liang. The relationship between serum tumor abnormal protein and mean platelet volume/lymphocyte ratio and the prognosis of patients with primary liver cancer undergoing laparoscopic hepatectomy[J]. Chinese Hepatolgy, 2024, 29(12): 1489-1492.

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参考文献

[1] Yanagaki M, Haruki K, Yasuda J, et al. The significance of the rapid turnover protein score as a predictor of the long-term outcomes in hepatocellular carcinoma after hepatic resection[J]. Ann Surg Oncol, 2021,28(13):8130-8139.
[2] Zhang J, Wang T, Xu L, et al. Thrombocytopenia predicts the prognosis of hepatocellular carcinoma patients with Ishak score 6 after hepatectomy: A propensity score matching analysis[J]. Asian J Surg, 2021,44(1):423-424.
[3] Sun T, Wang X, Cao L, et al. Laparoscopic liver resection for primary liver cancers originating in the paracaval portion of the caudate lobe: a preliminary retrospective analysis with 31 patients[J]. Updates Surg, 2022,74(2):547-555.
[4] Tong H, Dan B, Dai H, et al. Clinical application of serum tumor abnormal protein combined with tumor markers in lung cancer patients[J]. Future Oncol, 2022,18(11):1357-1369.
[5] Song Y, Tian J, Yang L, et al. Prognostic value of preoperative platelet-related parameters and plasma fibrinogen in patients with non-muscle invasive bladder cancer after transurethral resection of bladder tumor[J]. Future Oncol, 2022,18(26):2933-2942.
[6] Chiang MH, Tsai KY, Chen HA, et al. Comparison of surgical outcomes for laparoscopic liver resection of large hepatocellular carcinomas: a retrospective observation from single-center experience[J]. Asian J Surg, 2021,44(11):1376-1382.
[7] Goh BKP, Syn N, Koh YX, et al. Comparison between short and long-term outcomes after minimally invasive versus open primary liver resections for hepatocellular carcinoma: a 1:1 matched analysis[J]. J Surg Oncol, 2021,124(4):560-571.
[8] 胡勇军, 汪磊, 刘宁, 等. 间歇性全入肝血流阻断与区域性入肝血流阻断腹腔镜肝切除术治疗原发性肝癌患者术后恢复研究. 实用肝脏病杂志, 2022,25(3):411-414.
[9] Cai H, Li W, Zhang Y, et al. Preoperative tumor abnormal protein is a promising biomarker for predicting hepatocellular carcinoma oncological outcome following curative resection[J]. J Cancer Res Ther, 2022,18(7):2021-2026.
[10] Guan Y, Yin S, Liang C. Clinical value of prostate-specific antigen combined with tumor abnormal protein (TAP) in the diagnosis of prostate puncture[J]. Transl Cancer Res, 2020,9(1):58-64.
[11] 周新玲,王敏,荆信勇. 子宫内膜细胞学联合血清TAP检测对子宫内膜癌初筛价值[J]. 中华肿瘤防治杂志,2019,26(12):827-830.
[12] Zyczkowski M, Kaletka Z, Rajwa P, et al. Mean platelet volume-to-lymphocyte ratio: a novel biomarker associated with overall survival in patients with nonmetastatic clear cell renal cell carcinoma treated with nephrectomy[J]. Int Urol Nephrol, 2020,52(5):885-891.
[13] Sökmen FC, Ulucaköy C. Diagnostic and prognostic role of mean platelet volume and mean platelet volume/platelet ratio in patients with primary malignant bone tumor[J]. Jt Dis Relat Surg, 2021,32(1):198-203.
[14] Jung M, Lee JA, Yoo SY, et al. Intratumoral spatial heterogeneity of tumor-infiltrating lymphocytes is a significant factor for precisely stratifying prognostic immune subgroups of microsatellite instability-high colorectal carcinomas[J]. Mod Pathol, 2022,35(12):2011-2022.

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