维生素D结合蛋白在肝细胞癌中的作用机制及临床价值

Mechanisms and clinical value of vitamin D binding protein in hepatocellular carcinoma

摘要:

肝细胞癌（HCC）是原发性肝癌的主要类型，其发病率持续上升，患者预后较差。维生素D结合蛋白（VDBP）是一种肝脏来源的多功能糖蛋白，除转运维生素D外，还参与免疫调节、细胞凋亡、细胞骨架稳定及肿瘤相关信号转导等多种生物学过程。越来越多的研究表明，VDBP不仅在慢性肝病及肝纤维化进程中发挥作用，还可能通过调控肿瘤微环境、影响血管生成及免疫应答，参与HCC的发生、发展。该文综述了VDBP的结构与功能特征、在肝脏疾病及HCC中的表达变化、潜在的分子机制及临床应用前景，并探讨了VDBP在增强化疗、免疫治疗及靶向治疗敏感性方面的可能作用，以期为HCC的精准诊疗提供理论依据。

Abstract:

Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, continues to exhibit rising incidence and remains associated with a poor prognosis. Vitamin D binding protein (VDBP), a multifunctional glycoprotein primarily synthesized in the liver, not only mediates the transport of vitamin D but also participates in various biological processes, including immune modulation, apoptosis, cytoskeletal stability, and tumor-related signal transduction. Increasing evidence suggests that VDBP plays critical roles not only in chronic liver disease and hepatic fibrosis but also in the initiation and progression of HCC, potentially through the regulation of the tumor microenvironment, angiogenesis, and immune responses. This review summarizes the structural and functional characteristics of VDBP, its expression patterns in liver diseases and HCC, and its potential molecular mechanisms and clinical implications. Furthermore, it discusses the possible role of VDBP in enhancing the sensitivity to chemotherapy, immunotherapy, and targeted therapy, aiming to provide a theoretical basis for the precision diagnosis and treatment of HCC.