人软骨糖蛋白－39在原发性肝癌中的表达以及对 TACE术后患者预后的评估价值

摘要

Objective To analyze the expression of human cartilage glycoprotein 39(YKL-40)in hepatocellular carcinoma ( HCC) patients and the value of prognosis evaluation for postoperative patients under transhepatic artery chemotherapy embol-ism ( TACE) .Methods ELISA was applied to detect serum YKL-40 levels in 87 cases of first diagnosed HCC patients and 25 cases of healthy volunteers.54 patients who had undergone TACE operation were followed up,and their YKL-40 levels were re-tested after one month.Results The average value of YKL-40 in HCC patients was 331.4 ±126.8 pg/ml,obviously higher than that of healthy people (184.0 ±83.7 pg/ml).The elevated YKL-40 was associated with tumor size(P<0.05),and irrel-evant to gender,age,tumor embolus and AFP levels(P>0.05).The YKL-40 value decreased after TACE operation,but was still higher than that of healthy people(P<0.05).The overall survival time of postoperative patients with YKL-40≥331.4 pg/ml was significantly shorter than those with YKL-40<331.4 pg/ml group(P<0.05).COX regression analysis showed that postoperative YKL-40≥331.4 pg/ml was an independent risk factor influencing the prognosis of HCC patients after TACE op-eration.Conclusion YKL-40 expresses highly in HCC patients.Dynamically monitoring YKL-40 can be employed to judge the disease outcome and evaluate the prognosis of postoperative patients under TACE.%目的：分析人软骨糖蛋白39（YKL－40）在原发性肝癌（HCC）中的表达以及对TACE术后患者预后的评估价值。方法采用酶联免疫吸附法检测87例初诊原发性肝癌患者和25例健康志愿者血清YKL－40水平，同时对54例行肝动脉化疗栓塞（ TACE）术患者随访，并于术后1月复测YKL－40水平。结果初诊HCC患者YKL－40平均水平为（331．4±126．8）pg／ml，高于健康人群（184．0±83．7）pg／ml，差异具有统计学意义（P＜0．05）。 YKL－40水平升高与肿瘤大小有关（P＜0．05），与性别、年龄、有无癌栓、AFP水平无关（P＞0．05）。 TACE术后YKL－40平均水平较术前有所降低，但仍高于健康人群（P＜0．05）；其中术后YKL－40≥331．4 pg／ml组总体生存时间短于术后YKL－40＜331．4 pg／ml组（P＜0．05）；COX风险回归分析显示术后YKL－40≥331．4 pg／ml是影响HCC患者TACE术后预后的独立危险因素。结论 YKL－40在HCC患者中高表达，动态监测YKL－40可以用于了解TACE术后患者疾病转归，评估预后。