摘要
目的探究乙型肝炎病毒(HBV)感染原发性肝癌(PLC)患者高尔基体糖蛋白73(GP73)、α-L-岩藻糖苷酶(AFU)、25-羟基维生素D3[25(OH)D3]及其对肝动脉栓塞化疗(TACE)术后复发转移的诊断价值。方法选择2015年1月-2019年1月于南阳医学高等专科学校第一附属医院行TACE的PLC患者185例,根据术前HBV感染情况分为HBV组(n=79)和非HBV组(n=106),比较两组患者术前血清GP73、AFU、25(OH)D3水平,统计两组患者术后1、2及3年复发转移率,并采用受试者工作特征(ROC)曲线分析血清GP73、AFU、25(OH)D3对PLC患者TACE术后复发转移的诊断价值,采用Logistic回归分析影响TACE术后复发转移的危险因素。结果HBV组术前血清GP73、AFU水平均高于非HBV组(P<0.05),血清25(OH)D3水平低于非HBV组(P<0.05);PLC合并HBV感染高载量组术前血清GP73、AFU水平均高于低载量组(P<0.05),血清25(OH)D3水平低于低载量组(P<0.05);HBV组TACE术后1、2及3年复发率高于非HBV组(P<0.05),PLC患者TACE术后复发转移组血清GP73、AFU高于未复发转移组(P<0.05),25(OH)D3低于未复发转移组(P<0.05);血清GP73、AFU、25(OH)D3诊断PLC患者TACE术后复发转移的曲线下面积(AUC)分别为0.828、0.798和0.797,三者联合诊断的AUC为0.892,高于各指标单独诊断(P<0.05);HBV感染、GP73、AFU及25(OH)D3是TACE术后复发的危险因素(P<0.05)。结论HBV感染与PLC患者TACE术后复发转移相关,其可能通过影响PLC患者GP73、AFU及25(OH)D3表达发挥作用,针对性予以HBV抗感染治疗可能利于降低TACE术后复发转移风险。
OBJECTIVE To explore the levels of serum golgiprotein73(GP73),α-L-fucosidase(AFU)and 25-hydroxyvitamin D3[25(OH)D3]in patients with hepatitis B virus(HBV)infection complicated with primary liver cancer(PLC)and their diagnostic value for recurrence and metastasis after transcatheter arterial chemoembolization(TACE).METHODS Totally 185 patients with PLC who underwent TACE in the First Affiliated Hospital of Nanyang Medical College between Jan.2015 and Jan.2019 were selected and divided into HBV group(n=79)and non-HBV group(n=106)according to their preoperative HBV infection.The preoperative serum GP73,AFU and 25(OH)D3 were compared between the two groups.The recurrence and metastasis rate at 1,2 and 3 years after surgery were statistically analyzed in both groups.The diagnostic value of serum GP73,AFU and 25(OH)D3 on recurrence and metastasis in patients with PLC after TACE was analyzed using receiver operating characteristic(ROC)curves,and Logistic regression analysis was used to analyze the risk factors for recurrence and metastasis after TACE.RESULTS The levels of serum GP73 and AFU before surgery were higher in HBV group than those in non-HBV group(P<0.05),while the level of serum 25(OH)D3 was lower than that in non-HBV group(P<0.05).The levels of serum GP73 and AFU of patients with PLC and HBV infection in high-load group before surgery were higher than those in low-load group(P<0.05),while the level of serum 25(OH)D3 was lower than that in low-load group(P<0.05).The recurrence rates at 1 year,2 years and 3 years after TACE in HBV group were higher than those in non-HBV group(P<0.05).The levels of serum GP73 and AFU in recurrence and metastasis group of patients with PLC after TACE were higher than those in non-recurrence and metastasis group(P<0.05),while the level of 25(OH)D3 was lower than that in non-recurrence and metastasis group(P<0.05).The AUC values of serum GP73,AFU and 25(OH)D3 for the diagnosis of recurrence and metastasis in patients with PLC after TACE were 0.828,0.798 and 0.797,respectively,and the AUC of the combined diagnosis of the three was 0.892,which was higher than that of each indicator alone(P<0.05).HBV infection,GP73,AFU and 25(OH)D3 were risk factors for recurrence after TACE(P<0.05).CONCLUSION HBV infection was associated with the recurrence and metastasis in patients with PLC after TACE,possibly by affecting the expressions of GP73,AFU and 25(OH)D3 in patients with PLC,and targeted anti-infection therapy for HBV might help to reduce the risk of recurrence and metastasis after TACE.
作者
王芳芳
张国范
王琪
郭春霞
杨振浩
WANG Fang-fang;ZHANG Guo-fan;WANG Qi;GUO Chun-xia;YANG Zhen-hao(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第11期1660-1664,共5页
Chinese Journal of Nosocomiology
基金
河南省科研基金资助项目(2020K0211)。
