实用医学杂志 ›› 2021, Vol. 37 ›› Issue (23): 3036-3040.doi: 10.3969/j.issn.1006⁃5725.2021.23.015

• 临床研究 • 上一篇    下一篇

血清异常凝血酶原在中晚期肝癌患者中的表达及预后

薄维波 秦继宝 陈隽 陶祥平 章勇 闫朝春 朱洪波 郭加友 安仲武   

  1. 徐州医科大学附属连云港东方医院检验科(江苏连云港 222042)

  • 出版日期:2021-12-10 发布日期:2021-12-10
  • 通讯作者: 安仲武 E⁃mail:15261379410@163.com
  • 基金资助:

    江苏省连云港市卫生科技项目(编号:201927)

Expression of serum PIVKA⁃Ⅱ in advanced hepatocellular carcinoma and its relationship with prognosis

BO Weibo,QIN Jibao,CHEN Jun,TAO Xiangping,ZHANG Yong,YAN Chaochun,ZHU Hongbo,GUO Jiayou, AN Zhongwu.   

  1. Department of Clinical LaboratoryLianyungang Oriental Hospital Affiliated to Xuzhou Medical UniversityLianyungang 222042China 
  • Online:2021-12-10 Published:2021-12-10
  • Contact: AN Zhongwu E⁃mail:15261379410@163.com

摘要:

目的 探讨血清异常凝血酶原(PIVKA⁃Ⅱ)在中晚期肝细胞癌(HCC)患者血清中的表达及 与临床病理特征和预后的关系。方法 采用化学发光法分别对 105 例中晚期 HCC 患者、93 例良性肝病患 者、90 例健康人的血清 PIVKA⁃Ⅱ、AFP 水平进行检测;Kaplan⁃Meier 法绘制生存曲线,Log⁃rank 检验进行生 存差异比较;单因素、多因素 Cox 比例风险回归模型分析影响患者预后的独立危险因素;ROC 曲线分析血 PIVKA⁃Ⅱ、AFP 的诊断效能。结果 中晚期肝癌组血清 PIVKA⁃Ⅱ AFP 水平显著高于良性肝病组和对 照组(均 P < 0.05);血清 PIVKA⁃Ⅱ高表达与肿瘤大小、肿瘤数目、血管侵犯和 TNM 分期有关(均 P < 0.05); 低表达组 5 年总体生存期(OS)和 5 年无进展生存期(PFS)显著高于高表达组(均 P < 0.05);多因素分析显 示血清 PIVKA⁃Ⅱ表达是影响中晚期肝癌患者 5 OS、PFS 的独立危险因素(均 P < 0.05);ROC 曲线分析显 PIVKA⁃Ⅱ AFP 联合检测可显著提高诊断效能。结论 PIVKA⁃Ⅱ在中晚期肝癌患者血清中表达上调, 其高表达与多种不良临床病理特征及预后密切相关,可作为判断中晚期肝癌患者预后的重要生物 标志物。

关键词:

Abstract:

Objective To explore the expression of serum protein induced by vitamin K absence or antago⁃ nist ⁃Ⅱ(PIVKA ⁃Ⅱ)in advanced hepatocellular carcinoma(HCC)and its relationship with clinicopathological characteristics and prognosis. Methods Chemiluminescence method was used to detect serum PIVKA⁃Ⅱ and AFP levels in105 patients with advanced HCC,93 patients with benign hepatic diseases,and 90 healthy volunteers survival analysis was performed by Kaplan ⁃Meier method and Log ⁃ rank test;univariate and multivariate analysis were performed using the Cox proportional hazard analysis;the receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum PIVKA⁃Ⅱ and AFP in diagnosing of advanced HCC. Results The expression levels of PIVKA⁃Ⅱ and AFP in advanced HCC group were significantly higher than those in benign hepatic diseases and control group(P < 0.05);the high⁃expression of PIVKA⁃Ⅱ in advanced HCC patients were correlated with the tumor size,tumor number,vascular invasion and TNM stag(P < 0.05);the 5⁃year OS and PFS in low⁃expres⁃ sion group were significantly better than those in high ⁃expression group(P < 0.05);PIVKA ⁃Ⅱ high ⁃expression was independent risk factors affecting 5⁃year OS and PFS in advanced HCC patients(P < 0.05);the AUC of the combined detection of the two in the diagnosis of HCC is significantly higher than that of single detection(P < 0.05). Conclusion PIVKA⁃Ⅱ was up⁃regulated in advanced HCC patients and its high⁃expression was closely related with several unfavorable clinicopathological features and prognosis,and it might be an important biomarker for predicting the prognosis of advanced HCC.

Key words:

advanced hepatocellular carcinoma, protein induced by vitamin K absence or antagonist ?Ⅱ, expression, prognosis

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