摘要
目的探讨血清内皮特异性分子-1(ESM-1)与肝细胞癌(HCC)患者射频消融术(RFA)后早期复发的关系。方法收集2017年8月至2022年9月在我院接受RFA治疗的459例HCC患者病历资料。采用夹心酶联免疫吸附试验法检测血清ESM-1水平。随访患者首次治疗后2年内的早期复发情况,记录复发后生存期(PRS)。采用受试者工作特征(ROC)曲线评估血清ESM-1水平预测HCC患者RFA治疗后早期复发风险的诊断效能。Logistic回归分析影响HCC患者RFA治疗后早期复发的因素。Kaplan-meier法绘制PRS曲线,差异行Log-rank检验。结果随访至2022年9月30日,共366例(79.74%)患者发生复发,其中264例早期复发(≤2年),102例晚期复发(>2年)。早期复发HCC患者的中位PRS显著低于晚期复发患者(2.94年vs.4.01年,P<0.05)。复发组HCC患者血清ESM-1水平为14.71 ng/ml(8.28,31.92),显著高于未复发组的7.91 ng/ml(4.13,12.79),差异具有统计学意义(P<0.05);早期复发患者血清ESM-1水平为18.65 ng/ml(9.67,33.12),显著高于晚期复发患者的9.41 ng/ml(5.33,21.01),差异具有统计学意义(P<0.05)。ROC曲线结果显示,血清ESM-1水平可良好地预测HCC患者RFA治疗后早期复发风险,曲线下面积(AUC)为0.753(95%CI:0.693~0.812,P<0.05)。Logistic回归分析显示,病灶数量(P<0.05)、血清α甲胎蛋白(AFP)水平(P<0.05)和血清ESM-1水平(P<0.05)是影响HCC患者RFA治疗后早期复发的独立因素。RFA治疗后早期复发的HCC患者中,高血清ESM-1水平组患者中位PRS更短(1.40年vs.3.86年,P<0.05);AFP正常的早期复发HCC患者中,高血清ESM-1水平组中位PRS更短(2.19年vs.4.67年,P<0.05)。结论血清ESM-1可作为HCC患者RFA术后早期复发的预测生物标志物。
Objective To investigate the relationship between serum specific molecule 1(ESM-1)and early recurrence after radiofrequency ablation(RFA)in patients with hepatocellular carcinoma(HCC).Methods The medical records of 459 HCC patients who received RFA treatment in our hospital from August 2017 to September 2022 were collected.Use sandwich enzyme-linked immunosorbent assay to detect serum ESM-1 levels.Follow up the early recurrence status of the patient within 2 years after the first treatment,and record the survival time after recurrence(PRS).The diagnostic efficacy of using receiver operating characteristic(ROC)curves to evaluate serum ESM-1 levels for predicting early recurrence risk in HCC patients after RFA treatment.Logistic regression analysis of factors affecting early recurrence in HCC patients after RFA treatment.Kaplan-meier plotted the PRS curve and performed a log rank test for differences.Results As of September 30,2022,a total of 366 patients(79.74%)experienced recurrence,of which 264 had early recurrence(≤2 years)and 102 had late recurrence(>2 years).The median PRS of early recurrent HCC patients was significantly lower than that of late recurrent HCC patients(2.94 years vs.4.01 years,P<0.05).The serum ESM-1 level of HCC patients in the recurrent group was 14.71 ng/ml(8.28,31.92),significantly higher than the 7.91 ng/ml(4.13,12.79)in the non recurrent group,and the difference was statistically significant(P<0.05).The serum ESM-1 level in early recurrent patients was 18.65 ng/ml(9.67,33.12),significantly higher than the 9.41 ng/ml(5.33,21.01)in late recurrent patients,with a statistically significant difference(P<0.05).The ROC curve result showed that serum ESM-1 levels can effectively predict the risk of early recurrence in HCC patients after RFA treatment,with an area under the curve(AUC)of 0.753(95%CI:0.693-0.812,P<0.05).Logistic regression analysis showed that the number of lesions(P<0.05)and serumαThe levels of alpha fetoprotein(P<0.05)and serum ESM-1(P<0.05)are independent factors that affect
作者
仲伟明
吴银亚
段后张
刘雷
蔡景治
ZHONG Weiming;WU Yinya;DUAN Houzhang;LIU Lei;CAI Jingzhi(Department of Gastroenterology,No.904 Hospital of Joint Logistics Support Force,Wuxi 214000,China)
出处
《临床肿瘤学杂志》
2023年第10期907-912,共6页
Chinese Clinical Oncology
关键词
肝细胞癌
内皮特异性分子-1
射频消融术
早期复发
复发后生存期
Hepatocellular carcinoma
Endothelial cell-specific molecule 1
Radiofrequency ablation
Early recurrence
Postrecurrence survival
