原发性肝癌患者TACE术前后血清GP73水平变化及临床价值

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摘要目的探讨原发性肝癌（PHC）患者肝动脉化疗栓塞（TACE）术前后血清高尔基体蛋白73（GP73）水平变化的临床意义，以了解GP73能否作为TACE疗效的评价指标。方法收集四川省资阳市第一人民医院2016年9月～2018年10月88例PHC并行TACE患者入组，根据TACE治疗效果将其分为好转组（39例）与恶化组（49例）。统计在行TACE术前后GP73、甲胎蛋白（AFP）、肝功能的变化。结果与术前比较，好转组术后1周血清GP73水平升高，差异有统计学意义（P ＜ 0.05）；与术前及术后1周比较，好转组术后1个月血清GP73水平降低，差异有统计学意义（P ＜ 0.05）。与术前比较，恶化组血清GP73水平术后1周和术后1个月均升高，且术后1个月高于术后1周，差异均有统计学意义（均P ＜ 0.05）。好转组术后1周和术后1个月血清GP73水平均低于恶化组，差异均有统计学意义（均P ＜ 0.05）。TACE术前1周，血清GP73水平与AFP无相关性（rs = 0.056、0.192，P = 0.613、0.077）；血清GP73与总胆红素呈正相关（rs = 0.295，P = 0.006），与谷丙转氨酶呈正相关（rs = 0.301，P = 0.005）。结论 GP73或许可以作为PHC患者TACE术前后判断疗效的有效指标，且GP73可以反映PHC患者的肝功能情况，对于AFP阴性的患者GP73对于疗效监测的有效性需要进一步扩大样本量得出结论。

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	张莉肖伟陈匡荣张惠玲李辉邓丽聪张宏伟

关键词 ：原发性肝癌, 高尔基体蛋白73, 肝动脉化疗栓塞术

Abstract：Objective To investigate the clinical significance of changes of serum Golgi protein 73 (GP73) level in patients with primary hepatocellular carcinoma (PHC) undergoing transcatheter arterial chemoembolization (TACE) before and after operation, so as to understand whether GP73 can be used as an evaluation index of TACE efficacy. Methods A total of 88 patients with PHC concurrent TACE in the First People′s Hospital of Ziyang, Sichuan Province from September 2016 to October 2018 were enrolled and divided into the improvement group (39 cases) and the deterioration group (49 cases) according to the treatment effect of TACE. The changes of GP73, alpha-fetal protein (AFP) and liver function before and after TACE were recorded. Results The serum GP73 level in the improvement group decreased 1 week after operation compared with that before operation, with statistically significant difference (P ＜ 0.05). Compared with those before and 1 week after the operation, serum GP73 level in the improvement group decreased 1 month after operation, with statistically significant difference (P ＜ 0.05). Compared with that before operation, serum GP73 level in the deterioration group increased 1 week and 1 month after operation, and 1 month after operation was higher than 1 week after operation, with statistically significant differences (all P ＜ 0.05). Serum GP73 level in the improvement group was lower than that in the deterioration group 1 week and 1 month after operation, and the differences were statistically significant (all P ＜ 0.05). One week before TACE, serum GP73 level was not correlated with AFP (rs = 0.056, 0.192, P = 0.613,0.077). Serum GP73 was positively correlated with total bilirubin (rs = 0.295, P = 0.006), and positively correlated with alanine transaminase (rs = 0.301, P = 0.005). Conclusion GP73 may be an effective indicator for evaluating the efficacy of TACE in PHC patients before and after operation, and can reflect the liver function of PHC patients. Effectiveness of GP73 in efficacy monitoring in patients with AFP negative needs to be further expanded to draw conclusions.

Key words： Primary hepatocellular carcinoma Golgi protein 73 Transcatheter arterial chemoembolization

基金资助:四川省卫生和计划生育委员会科研课题普及应用项目（16PJ594）。

通讯作者: 张宏伟（1977.6-），男，硕士，资阳市第一人民医院肿瘤科主任；研究方向：肿瘤介入治疗。

作者简介: 张莉（1994.5-），女，硕士；研究方向：肿瘤血液。

引用本文:

张莉肖伟陈匡荣张惠玲李辉邓丽聪张宏伟. 原发性肝癌患者TACE术前后血清GP73水平变化及临床价值[J]. 中国医药导报, 2020, 17(20): 127-130,139.
ZHANG Li XIAO Wei CHEN Kuangrong ZHANG Huiling LI Hui DENG Licong ZHANG Hongwei. Changes of serum GP73 level in patients with primary hepatocellular carcinoma before and after TACE and its clinical value. 中国医药导报, 2020, 17(20): 127-130,139.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I20/127

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