| 崔娜.肝细胞癌患者血清PIVKA-Ⅱ、CDK4水平变化及预后预测价值[J].安徽医药,待发表. |
| 肝细胞癌患者血清PIVKA-Ⅱ、CDK4水平变化及预后预测价值 |
|
| 投稿时间：2025-03-24 录用日期：2025-04-18 |
| DOI： |
| 中文关键词: 肝细胞癌 异常凝血酶原Ⅱ 细胞周期蛋白依赖性激酶4 预后 |
| 英文关键词: |
| 基金项目: |
|
| 摘要点击次数: 81 |
| 全文下载次数: 0 |
| 中文摘要: |
| 【】目的:探讨肝细胞癌患者血清异常凝血酶原Ⅱ(PIVKA-Ⅱ)、细胞周期蛋白依赖性激酶4(CDK4)水平变化及预后预测价值。方法:选取2022年1月~2023年6月医院收治的98例肝细胞癌患者,另选取同期93例肝硬化患者、87例乙型肝炎患者和92例健康体检者,比较四组患者血清PIVKA-Ⅱ、CDK4水平。根据肝细胞癌患者预后情况,分为死亡组(n=31)和存活组(n=67),分析影响肝细胞癌患者预后因素,并分析血清PIVKA-Ⅱ、CDK4水平预测肝细胞癌患者死亡的价值。结果:各组间血清PIVKA-Ⅱ、CDK4水平比较,差异均有统计学意义(P<0.05),肝细胞癌患者血清PIVKA-Ⅱ、CDK4水平均高于肝硬化、乙型肝炎、健康体检者(P<0.05)；肝硬化患者血清PIVKA-Ⅱ、CDK4水平均高于乙型肝炎、健康体检者(P<0.05)；乙型肝炎血清PIVKA-Ⅱ、CDK4水平均高于健康体检者(P<0.05)；两组患者性别、年龄、分化程度、临床分期、Child-Pugh分级、血清谷草转氨酶、谷丙转氨酶、总胆红素水平比较,差异均无统计学意义(P>0.05),死亡组肝内淋巴结转移、肝内血管侵犯占比、血清PIVKA-Ⅱ、CDK4水平均高于存活组(P<0.05)；肝内血管侵犯、血清PIVKA-Ⅱ、CDK4水平均是影响肝细胞癌患者死亡的独立危险因素(P<0.05)；血清PIVKA-Ⅱ、CDK4水平预测肝细胞癌患者死亡的最佳截断点分别为59.52 ng/mL、0.42 ng/mL,曲线下面积分别为0.818、0.849,二者联合的特异度和曲线下面积分别为97.01%、0.901。结论:肝细胞癌患者血清PIVKA-Ⅱ、CDK4水平均异常升高,二者均可预测肝细胞癌患者死亡,且联合预测准确性更高。 |
| 英文摘要: |
| Objective: To explore the changes of serum abnormal prothrombin Ⅱ (PIVKA-Ⅱ) and cyclin-dependent kinase 4 (CDK4) levels and their prognostic value in patients with hepatocellular carcinoma. Methods: 98 patients with hepatocellular carcinoma admitted to the hospital from January 2022 to June 2023 were selected, and 93 patients with cirrhosis, 87 patients with hepatitis B and 92 healthy subjects were selected during the same period. The serum levels of PIVKA-Ⅱ and CDK4 were compared among the four groups. They were divided into death group (n=31) and survival group (n=67) according to the prognosis of HCC patients. The prognostic factors affecting HCC patients were analyzed, and the value of serum PIVKA-Ⅱ and CDK4 levels in predicting HCC patients" death was analyzed. Results: Serum PIVKA-Ⅱ and CDK4 levels were significantly different among all groups (P<0.05). Serum PIVKA-Ⅱ and CDK4 levels in hepatocellular carcinoma patients were higher than those in cirrhosis, hepatitis B and healthy subjects (P<0.05). The levels of PIVKA-Ⅱ and CDK4 in patients with liver cirrhosis were higher than those in healthy subjects (P<0.05). Serum PIVKA-Ⅱ and CDK4 levels of hepatitis B were higher than those of healthy subjects (P<0.05). There was no significant difference in gender, age, differentiation degree, clinical stage, Child-Pugh grade, serum levels of aspartate aminotransferase, alanine aminotransferase and total bilirubin in both groups (P>0.05). Hepatic lymph node metastasis, the proportion of hepatic vascular invasion, serum PIVKA-Ⅱ and CDK4 levels in death group were higher than those in survival group (P<0.05). Hepatic vascular invasion, serum PIVKA-Ⅱ and CDK4 levels were independent risk factors for death in patients with hepatocellular carcinoma (P<0.05). The optimal cut-off points of serum PIVKA-Ⅱ and CDK4 levels for predicting the death of hepatocellular carcinoma patients were 59.52 ng/mL and 0.42 ng/mL, and the area under? curve were 0.818 and 0.849, respectively. The combined specificity and area under curve were 97.01% and 0.901, respectively. Conclusion: Serum levels of PIVKA-Ⅱ and CDK4 were abnormally elevated in patients with hepatocellular carcinoma, and both of them could be used as sensitive indicators to predict death in patients with hepatocellular carcinoma, and the combined prediction is more accurate. |
|
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
