关键词: 肝细胞癌, 丝氨酸蛋白酶抑制剂Kazal 1型, 预后

Abstract: Objective To analyze plasma levels of serine protease inhibitor Kazal 1（SPINK1） in patients with hepatocellular carcinoma（HCC） and its relationship with prognosis. Methods 80 patients with HCC,40 patients with liver cirrhosis and 30 normal persons in our hospital between May 2014 and September 2015 were retrospectively analyzed. The plasma SPINK1 and alpha-fetoprotein （AFP） levels were measured by enzyme-linked immunosorbent assay （ELISA） before hepatectomy. The ROC was drawn to evaluate the efficacy of plasma SPINK1 and AFP to diagnose HCC,and the relationship between the SPINK1 levels and the prognosis of patients with HCC was analyzed. Results The plasma SPINK1 level was （2.4±0.3） μg/L in the HCC patients,much higher than （2.0±0.2） μg/L in the liver cirrhosis patients or（1.3±0.1） μg/L in normal control（P<0.05）;plasma AFP levels was （125.7±14.5） μg/L in the HCC patients,significantly higher than （35.4±4.2） μg/L in patients with liver cirrhosis or in normal persons【（3.6±0.5）μg/L,P<0.05】;the ROC analysis showed that the sensitivity and the specificity of plasma SPINK1 were 77.2% and 67.6%,respectively,in diagnosing HCC as the cut-off-value was 1.70 μg/L,while the sensitivity and the specificity of plasma AFP were 63.4% and 62.5% as the cut-off-value was 124.8 μg/;the postoperative OS and DFS were（12.2±1.3） m and（11.2±1.2） m in 42 HCC patients with preoperative serum SPINK1 levels >1.70 μg/L,much shorter than（20.5±2.1） m and（15.7±1.9） m in 38 HCC patients with preoperative SPINK1 levels less than 1.70 μg/L,and the recurrence rates after operation were significantly different between the two groups（38.1% vs. 18.4%,x²=5.18,P<0.05）. Conclusions Plasma level of SPINK1 is high in HCC patients,which might be act as a new marker for diagnosis of patients with HCC, and increased plasma SPINK1 might be closely related to the poor prognosis of HCC patients after hepatectomy.

Key words: Hepatocellular carcinoma, Serine protease inhibitor Kazal 1, Prognosis