血清PIVKA-Ⅱ、CHI3L1、TFF-1水平在原发性肝癌患者中的变化及临床意义

Changes and Clinical Significance of Serum PIVKA-Ⅱ, CHI3L1 and TFF-1 Levels in Patients with Primary Liver Cancer

摘要

目的 分析血清异常凝血酶原-Ⅱ（PIVKA-Ⅱ）、壳多糖酶3样蛋白1（CHI3L1）、三叶肽因子-1（TFF-1）水平在原发性肝癌患者中的变化及其临床意义。方法 选取2021年7月~2023年2月鹤壁市人民医院收治的肝癌患者97例为研究组,另选取同期56例肝硬化患者为对照组。比较2组入院时血清PIVKA-Ⅱ、CHI3L1、TFF1水平;比较不同病理学参数（肿瘤直径、TNM分期、分化程度）原发性肝癌患者血清PIVKA-Ⅱ、CHI3L1、TFF1水平;分析不同病理学参数与血清PIVKA-Ⅱ、CHI3L1、TFF1水平的相关性及联合诊断价值。结果 入院时研究组血清PIVKA-Ⅱ、CHI3L1、TFF-1水平高于对照组（P<0.05）;不同病理学参数原发性肝癌患者血清PIVKA-Ⅱ、CHI3L1、TFF1水平比较：肿瘤直径（≤5cm）低于肿瘤直径（>5cm）、Ⅰ~Ⅱ期低于Ⅲ~Ⅳ期（P<0.05）;低分化程度肝癌患者血清PIVKA-Ⅱ水平高于中高分化程度肝癌患者,血清CHI3L1、TFF1水平低于中高分化程度肝癌患者（P<0.05）;入院时血清PIVKA-Ⅱ水平与肿瘤直径、TNM分期呈正相关,与分化程度呈负相关（P<0.05）;血清CHI3L1、TFF1水平与肿瘤直径、TNM分期呈正相关（P<0.05）;入院时血清PIVKA-Ⅱ、CHI3L1、TFF1水平联合诊断原发性肝癌的AUC为0.903（P<0.05）。结论 血清PIVKA-Ⅱ、CHI3L1、TFF-1水平与原发性肝癌患者病情关系密切,可作为临床制定治疗方案的重要参考指标。

Abstract

Objective To analyze the changes and clinical significance of abnormal serum levels of prothrombine-Ⅱ (PIVKA-Ⅱ), chitosinase 3-like protein-1 (CHI3L1) and trefoil peptide factor-1 (TFF-1) in patients with primary liver cancer. Methods Ninety-seven patients with liver cancer admitted to our hospital from July 2021 to February 2023 were selected as the study group, and 56 patients with cirrhosis were selected as the control group. The serum levels of PIVKA-Ⅱ, CHI3L1 and TFF1 were compared between the two groups at admission. The serum levels of PIVKA-Ⅱ, CHI3L1 and TFF1 in patients with primary liver cancer were compared with different pathological parameters (tumor diameter, TNM stage and differentiation degree). The correlation and combined diagnostic value of different pathologic parameters with serum PIVKA-Ⅱ, CHI3L1 and TFF1 levels were analyzed. Results The serum levels of PIVKA-Ⅱ, CHI3L1 and TFF-1 in the study group were higher than those in the control group (P<0.05). Comparison of serum PIVKA-Ⅱ, CHI3L1 and TFF1 levels in patients with primary liver cancer with different pathological parameters: tumor diameter (≤5cm) was lower than that of tumor diameter (>5cm), and stage I to Ⅱ was lower than stage III to stage IV (P<0.05); the serum PIVKA-Ⅱ levels in low-differentiated HCC patients were higher than those in medium-differentiated HCC patients, and the serum CHI3L1 and TFF1 levels were lower than those in medium-differentiated HCC patients (P<0.05). At admission, serum PIVKA-Ⅱ level was positively correlated with tumor diameter and TNM stage, but negatively correlated with differentiation degree (P<0.05). Serum CHI3L1 and TFF1 levels were positively correlated with tumor diameter and TNM stage (P<0.05). At admission, the AUC of serum PIVKA-Ⅱ, CHI3L1 and TFF1 levels combined with the diagnosis of primary liver cancer was 0.903 (P<0.05). Conclusion Serum PIVKA-Ⅱ, CHI3L1 and TFF-1 levels are closely related to the disease of patients with primary liver cancer, which can be used as an important reference index for clinical treatment.

关键词

原发性肝癌 / 异常凝血酶原-Ⅱ / 壳多糖酶3样蛋白1 / 三叶肽因子-1

Key words

isosorbide mononitrate / β-receptor blocker / acute myocardial infarction / myocardial fatty acid binding protein

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