摘要
目的探讨血清程序性细胞死亡蛋白5(PDCD5)在肝细胞癌(HCC)诊断和预后预测中的临床价值。方法收集2014年5月至2016年8月184例HCC患者,其中147例接受根治性手术切除,37例接受经导管动脉化疗栓塞术(TACE)。同时收集150例健康志愿者作为健康对照组和152例无恶性肿瘤病史的慢性乙型肝炎或肝硬化患者作为阴性对照组。采用酶联免疫吸附法(ELISA)测定全组患者血清PDCD5基线水平,采用受试者工作特征(ROC)曲线评价PDCD5的诊断效能,采用Cox多因素分析评价PDCD5的预后预测价值。结果HCC组血清PDCD5水平为2.30(0.81,11.45)ng/ml,低于健康对照组的9.81(4.93,16.75)ng/ml和阴性对照组的5.77(3.90,14.56)ng/ml,3组比较差异有统计学意义(P<0.001)。对于根治性切除组患者,血清PDCD5基线水平与甲胎蛋白水平、肿瘤数量、肿瘤最大径、Edmondson分级和BCLC分期有关(P<0.05),而TACE组患者血清PDCD5基线水平只与肿瘤数量有关(P<0.05)。经ROC曲线分析,血清PDCD5基线水平可良好地预测HCC或早期HCC(BCLC 0+A期),曲线下面积(AUC)分别为0.869和0.852,灵敏度分别为59.24%和50.39%,特异度分别为90.33%和91.33%。此外AFP联合PDCD5用于HCC或早期HCC的诊断灵敏度较AFP单独诊断提高至84.50%和81.64%,AUC提高至0.911和0.892。基线PDCD5<2.30 ng/ml的患者中位至复发时间(TTR:16.8个月vs.未达到,P<0.001),中位至疾病进展时间(TTP:11.2个月vs.18.0个月,P=0.011)和中位总生存时间(OS,根治性切除:32.0个月vs.未达到,P<0.001;TACE:14.8个月vs.未达到,P=0.015)短于PDCD5≥2.30 ng/ml的患者。Cox多因素分析显示,血清PDCD5基线水平是影响可手术切除HCC患者TTR和OS的独立因素(P<0.05)。结论血清PDCD5有望成为HCC诊断、预后预测和治疗反应评估的生物标志物。
Objective To investigate the clinical value of serum programmed cell death 5(PDCD5)in diagnosis and outcome prediction for patients with hepatocellular carcinoma(HCC).Methods From May 2014 to August 2016,serum PDCD5 level was measured by ELISA in 184 HCC patients,of whom 147 underwent radical surgical resection and 37 underwent transcatheter arterial chemoembolization(TACE).Meanwhile,150 healthy volunteers were collected as the healthy control group and 152 patients with chronic hepatitis B or cirrhosis without a history of malignant tumor were collected as the negative control group.The diagnostic performance of PDCD5 was evaluated by receiver operating characteristic(ROC)curve,and the prognostic value was evaluated by Cox regression model.Results The level of serum PDCD5 in HCC group was 2.30(0.81,11.45)ng/ml,which was lower than 9.81(4.93,16.75)ng/ml in healthy control group and 5.77(3.90,14.56)ng/ml in negative control group,with statistical significance(P=0.001).The serum level of PDCD5 was correlated with AFP level,tumor number,maximum tumor diameter,Edmondson grading and BCLC staging(P<0.05),and the level of serum PDCD5 in TACE group was only correlated with the number of tumor(P<0.05).The ROC curve analysis showed that the baseline level of serum PDCD5 could well predict HCC or early HCC(BCLC stage 0+A),the area under curve(AUC)was 0.869 and 0.852,the sensitivity was 59.24%and 50.39%,and the specificity was 90.33%and 91.33%.In addition,the sensitivity of AFP combined with PDCD5 for diagnosis of HCC or early HCC was increased to 84.50%and 81.64%,and AUC was increased to 0.911 and 0.892,compared with AFP alone.The median time to response(TTR:16.8 months vs.not achieved,P<0.001),median time to progression(TTP:11.2 months vs.18.0 months,P=0.011)and median overall survival(OS,radical resection:32.0 months vs.not achieved,P<0.001;TACE:14.8 months vs.not achieved,P=0.015)in patients with baseline PDCD5<2.30 ng/ml were significantly shorter.Cox multivariate analysis showed that PDCD5 was the independent predictor
作者
许继凡
杜波
蒲俊
王雪芬
XU Jifan;DU Bo;PU Jun;WANG Xuefen(Department of Hepatobiliary Surgery,People's Hospital of Kaizhou District,Chongqing 405400,China)
出处
《临床肿瘤学杂志》
CAS
2022年第11期982-989,共8页
Chinese Clinical Oncology
基金
重庆市开州区科技局指导性项目(2020-Z-02-20)。
关键词
肝细胞癌
程序性细胞死亡蛋白5
早期诊断
预后
Hepatocellular carcinoma
Programmed cell death 5
Early diagnosis
Prognosis
