摘要
目的探讨血清高尔基体蛋白73(Golgiprotein73,GP73)联合预后营养指数(prognostic nutritional index,PNI)对肝细胞癌(hepatocellular carcinoma,HCC)患者经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)术后预后的评估价值。方法选取2020年1月至2023年1月赣州市人民医院接受TACE的HCC患者231例,根据TACE术后1年预后(肿瘤进展或死亡)将HCC患者分为不良预后组(81例)和良好预后组(150例),收集患者的临床资料并检测GP73、计算PNI。分析TACE术后预后的影响因素,并绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评价血清GP73联合PNI的评估价值。结果随访1年,81例患者出现肿瘤进展或死亡,不良预后发生率为35.06%。单因素分析显示,年龄、Child-Pugh分级、甲胎蛋白、分化程度、中国肝癌分期(Chinaliver cancer staging,CNLC分期)、血管侵犯、GP73、PNI与HCC患者TACE术后不良预后有关(P<0.05)。多因素非条件Logistic回归分析结果显示,Child-Pugh分级B级、CNLC分期Ⅲa期、血管侵犯、GP73升高均为HCC患者TACE术后不良预后的独立危险因素,PNI升高为独立保护因素(P<0.05)。血清GP73联合PNI评估HCC患者TACE术后不良预后的曲线下面积为0.870,优于二者单独评估。结论血清GP73水平升高和PNI降低均是HCC患者TACE术后不良预后的独立影响因素,血清GP73联合PNI对HCC患者TACE术后不良预后的评估价值较高。
Objective To investigate the value of serum Golgi protein 73(GP73)combined with prognostic nutritional index(PNI)in evaluating the prognosis of hepatocellular carcinoma(HCC)patients after transcatheter arterial chemoembolization(TACE).Methods A total of 231 HCC patients who underwent TACE in Ganzhou People’s Hospital from January 2020 to January 2023 were selected.Based on the 1-year post-TACE prognosis(tumor progression or death),the patients were divided into poor prognosis group(81 cases)and good prognosis group(150 cases).Clinical data of patients were collected,GP73 was detected,and PNI was calculated.Prognostic factors after TACE were analyzed,and the predictive value of combined serum GP73 and PNI was evaluated using receiver operating characteristic(ROC)curves.Results After 1 year of follow-up,81 patients had tumor progression or death,and the incidence of poor prognosis was 35.06%.Univariate analysis showed that age,Child-Pugh grade,alpha-fetoprotein,differentiation degree,China liver cancer staging,vascular invasion,GP73 and PNI were associated with poor prognosis after TACE in HCC patients(P<0.05).Multivariate Logistic regression analysis showed that Child-Pugh grade B,CNLC stageⅢa,vascular invasion and GP73 elevation were independent risk factors for poor prognosis after TACE in HCC patients,and PNI elevation was independent protective factor(P<0.05).The area under the curve of serum GP73 combined with PNI in assessment of poor prognosis after TACE in HCC patients was 0.870,which was better than the two assessments alone.Conclusion Elevated serum GP73 levels and decreased PNI are independent factors associated with poor prognosis in HCC patients after TACE.The combined evaluation of serum GP73 and PNI offers a higher prognostic value for assessing post-TACE outcomes in HCC patients.
作者
周林
杨佳
ZHOU Lin;YANG Jia(Department of Hepatobiliary Pancreatic Surgery,Ganzhou People’s Hospital,Ganzhou 341000,Jiangxi,China;Department of Sports Medicine,Ganzhou People’s Hospital,Ganzhou 341000,Jiangxi,China)
出处
《中国现代医生》
2024年第34期6-9,19,共5页
China Modern Doctor
基金
江西省卫生健康委科技计划项目(202212440)。
关键词
肝细胞癌
高尔基体蛋白73
预后营养指数
经导管动脉化疗栓塞
预后
Hepatocellular carcinoma
Golgi protein 73
Prognostic nutritional index
Transcatheter arterial chemoembolization
Prognosis
