| 陈娟,朴瑛,高金平,等.免疫因子 γ干扰素、肿瘤坏死因子 α、甲胎蛋白异质体在肝细胞癌中的表达及与病理参数、预后的相关性[J].安徽医药,2025,29(9):1838-1843. |
| 免疫因子 γ干扰素、肿瘤坏死因子 α、甲胎蛋白异质体在肝细胞癌中的表达及与病理参数、预后的相关性 |
| Expression of immune factors IFN-γ, TNF-α and AFP-L3 in hepatocellular carcinoma and correlation analysis with pathological parameters and prognosis |
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| DOI：10.3969/j.issn.1009-6469.2025.09.029 |
| 中文关键词: 癌，肝细胞 γ干扰素 肿瘤坏死因子 α 甲胎蛋白异质体 临床病理参数 预后 |
| 英文关键词: Carcinoma,hepatocellular Interferon-γ Tumor necrosis factor-α Alpha-fetoprotein heterodimer Clinicopathologi-cal parameters Prognosis |
| 基金项目:辽宁省科学技术计划项目( 2019-ZD-1054) |
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| 中文摘要: |
| 目的探讨原发性肝细胞癌( HCC)血清中 γ干扰素( IFN-γ)、肿瘤坏死因子 α(TNF-α)、甲胎蛋白异质体( AFP-L3)的表达与临床病理参数、预后的关系。方法选取 2018年 2月至 2021年 2月中国人民解放军北部战区总医院接诊的 110例 HCC病人作为 HCC组，并选取同时期来院体检的 90例体检健康者作为对照组，收集两组入院时 IFN-γ、TNF-α、AFP-L3，分析 IFN-γ、 TNF-α、AFP-L3与病理参数之间的关系。共随访 36个月，采用 Cox回归单因素、多因素模型分析影响 HCC病人预后的相关因素。对不同预后病人的 IFN-γ、TNF-α、AFP-L3进行 Point-biserial相关性分析。结果与对照组比较， HCC组病人的 IFN-γ水平［( 77.26±16.46)ng/L比( 96.85±35.27)ng/L］明显降低，而 TNF-α［( 258.41±61.28)ng/L比( 150.82±114.83)ng/L］和 AFP-L3水平［( 16.08±2.19)%比( 0.28±0.05)%］明显升高。不同病理参数下，与 BCLC分期极早期 -中期、中高分化、淋巴结未发生转移的病人相比， BCLC分期晚期、低分化、淋巴结发生转移病人的 IFN-γ水平明显降低，而 TNF-α和 AFP-L3水平明显升高。 Kaplan-Meier结果显示， BCLC分期、 IFN-γ、AFP-L3、TNF-α、分化程度、淋巴结转移均与生存时间有关( P<0.05)。多因素 Cox回归模型中，淋巴结发生转移、 AFP-L3≥10.26%、TNF-α≥216.27 ng/L、IFN-γ<82.23 ng/L、低分化均是 HCC病人预后的独立影响因素。 Point-biserial相关性分析发现， TNF-α、AFP-L3与不良预后之间呈现明显正相关性( r=0.47、0.49，P<0.05)IFN-γ与不良预后之间呈现明显负相关性( r=.0.41，P<0.05)。结论 IFN-γ在 HCC病人中呈低水平表达且 TNF-α、AFP-L3呈高表，达水平，三者均与 HCC病人临床分期、转移、分化有一定的相关性，且是影响 HCC病人预后的独立影响因素。 |
| 英文摘要: |
| Objective To investigate the relationship between the expression of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) and alpha-fetoprotein (AFP-L3) in serum of primary hepatocellular carcinoma (HCC) and the clinicopathological parameters and prognosis.Methods A total of 110 HCC patients admitted to General Hospital of Northern Theater Command, People's Liberation Ar-my of China from February 2018 to February 2021 were selected as the HCC group, and 90 healthy subjects who came to the hospitalfor physical examination during the same period were selected as the control group. IFN-γ, TNF-α and AFP-L3 were collected and com-pared between the two groups at admission. The relationship between IFN-γ, TNF-α, AFP-L3 and pathological parameters was ana-lyzed. A total of 36 months of follow-up were used to analyze the prognostic factors of HCC patients by Cox regression univariate and multivariate models. Point-biserial correlation analysis was conducted for IFN-γ, TNF-α and AFP-L3 in patients with different progno-sis.Results Compared with the control group, the levels of IFN-γ in HCC group were significantly decreased [(77.26±16.46) ng/L vs. (96.85±35.27) ng/L], while the levels of TNF-α [(258.41±61.28) ng/L vs. (150.82±114.83) ng/L] and AFP-L3 [(16.08±2.19)% vs. (0.28± 0.05)% ] were significantly increased. Under different pathological parameters, IFN-γ levels were significantly decreased in patients with advanced, low-differentiated BCLC and lymph node metastasis, while TNF-α and AFP-L3 levels were significantly increased in pa-tients with very early to middle stage BCLC and medium-highly differentiated BCLC with no lymph node metastasis. Kaplan-Meier re-sults showed that BCLC stage, IFN-γ, AFP-L3, TNF-α, differentiation degree and lymph node metastasis were all correlated with sur-vival time (P<0.05). In multivariate Cox regression model, lymph node metastasis, AFP-L3≥10.26%, TNF-α ≥216.27 ng/L, IFN-γ<82.23 ng/L, and low differentiation were all independent prognostic factors of HCC patients. Point-biserial correlation analysis found that TNF-α and AFP-L3 were significantly positively correlated with adverse prognosis (r=0.47, 0.49, P<0.05), while IFN-γ was signifi-cantly negatively correlated with adverse prognosis (r=.0.41, P<0.05).Conclusion IFN-γ is expressed at a low level and TNF-α and AFP-L3 are expressed at a high level in HCC patients, all of which are correlated with the clinical stage, metastasis and differentiationof HCC patients, and are independent factors affecting the prognosis of HCC patients. |
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