血浆热休克蛋白90α联合血清circDUSP16对肝细胞肝癌介入治疗预后的预测价值

Prognostic value of plasma heat shock protein 90α combined with serum circDUSP16 for hepatocellular carcinoma after interventional therapy

摘要:

目的 分析血浆热休克蛋白90α（HSP90α）联合血清circDUSP16对肝细胞肝癌介入治疗预后的预测效能。方法 回顾性分析2019年4月—2021年6月榆林市中医医院收治的89例经肝动脉化疗栓塞术（TACE）肝细胞肝癌患者的临床资料。根据患者3年预后将其分为死亡组、生存组。对比两组临床资料、血浆HSP90α与血清circDUSP16，分析肝细胞肝癌患者TACE治疗后死亡的影响因素，分析血浆HSP90α、血清circDUSP16及其联合对肝细胞肝癌患者TACE治疗后死亡的预测价值。结果 随访3年，生存率为68.54%（61/89）。死亡组AFP水平>400 μg/L、肿瘤直径>5 cm和肿瘤分期为Ⅳa期比例均高于生存组（P <0.05）。死亡组血浆HSP90α水平和血清circDUSP16相对表里量均高于生存组（P <0.05）。多因素一般Logistic回归分析，结果表明，肿瘤分期Ⅳa期［O^R=4.175（95% CI：1.670，10.434）］、肿瘤最大直径>5 cm ［O^R=3.732（95% CI：1.493，9.329）］、血浆HSP90α水平高［O^R=2.770（95% CI：1.108，6.925）］和血清circDUSP16相对表达量高［O^R=3.047（95% CI：1.219，7.615）］均为肝细胞肝癌患者死亡的危险因素（P <0.05）。ROC曲线结果显示，血浆HSP90α、血清circDUSP16及其联合预测肝细胞肝癌患者TACE治疗后死亡的敏感性分别为78.57%（95% CI：0.699，0.856），85.71%（95% CI：0.763，0.934）和89.29%（95% CI：0.795，0.973）；特异性分别为83.61%（95% CI：0.744，0.911），81.97%（95 %CI：0.730，0.893）和93.44%（95% CI：0.832，0.992）；曲线下面积分别为0.795（95% CI：0696，0.879）、0.839（95% CI：0.749，0.915）、0.907（95% CI：0.826，0.961）。结论 血浆HSP90α联合血清circDUSP16预测肝细胞肝癌介入治疗预后价值更高。

Abstract:

Objective To evaluate the prognostic value of plasma heat shock protein 90α (HSP90α) combined with serum circDUSP16 for hepatocellular carcinoma after interventional therapy.Methods A retrospective analysis was conducted on the clinical data of 89 patients with hepatocellular carcinoma who underwent transhepatic arterial chemoembolization (TACE) at Yulin Hospital of Traditional Chinese Medicine from April 2019 to June 2021. The patients were classified into the death group and the survival group based on their 3-year prognosis. The clinical characteristics and the levels of plasma HSP90α and serum circDUSP16 were compared between the two groups, and the influencing factors for death after TACE treatment in patients with hepatocellular carcinoma were analyzed. The predictive value of plasma HSP90α, serum circDUSP16 and their combination for death after TACE treatment in patients with hepatocellular carcinoma was determined.Results After a 3-year follow-up, the overall survival rate was 68.54% (61/89). The proportions of patients with AFP levels > 400 μg/L, tumor diameter > 5 cm, and stage IVa tumor were higher in the death group than in the survival group (P < 0.05). The levels of plasma HSP90α and serum circDUSP16 in the death group were higher than those in the survival group (P < 0.05). Multivariable logistic regression analysis showed that stage Ⅳa tumor [O^R = 4.175 (95% CI:1.670, 10.434) ], maximum tumor diameter > 5 cm [O^R = 3.732 (95% CI:1.493, 9.329) ], and high levels of plasma HSP90α [O^R = 2.770 (95% CI:1.108, 6.925) ] and serum circDUSP16 [O^R = 3.047 (95% CI:1.219, 7.615) ] were risk factors for the death of patients with hepatocellular carcinoma (P < 0.05). The receiver operating characteristic (ROC) curve revealed that the sensitivities of plasma HSP90α, serum circDUSP16 and their combination in predicting the death of patients with hepatocellular carcinoma after TACE were 78.57% (95% CI: 0.699, 0.856), 85.71% (95% CI: 0.763, 0.934) and 89.29% (95% CI: 0.795, 0.973), with the specificity being 83.61% (95% CI: 0.744, 0.911), 81.97% (95% CI: 0.730, 0.893) and 93.44% (95% CI: 0.832, 0.992), and the areas under the curves being 0.795 (95% CI: 0696, 0.879), 0.839 (95% CI: 0.749, 0.915) and 0.907 (95% CI: 0.826, 0.961), respectively (P < 0.05).Conclusion Plasma HSP90α combined with serum circDUSP16 has higher prognostic value for hepatocellular carcinoma following interventional therapy.