关键词: 肝细胞癌, 热休克蛋白90α, 维生素K拮抗剂诱导蛋白-Ⅱ, 预后评估

Abstract: Objective The aim of this study was to explore the value of serum heat shock protein 90α (HSP90α) and protein-induced by vitamin K antagonist-II (PIVKA-II) in prognosis of patients with hepatocellular carcinoma (HCC). Methods A total of 112 patients with HCC, 96 patients with hepatitis B liver cirrhosis, 82 patients with chronic hepatitis B, and 84 healthy persons were enrolled in our hospital between January 2014 and June 2016, and all patients with HCC underwent transcatheter arterial chemoembolization (TACE). Serum HSP90α and PIVKA-II levels were detected by ELISA. The ROC was applied to evaluate the efficacy of serum parameters for the prognosis of patients with HCC after TACE. Results Serum Hsp90 α and PIVKA-II levels in HCC group were (61.6±5.0) ng / mL and (832.6±66.7) mAU / mL, significantly higher than [13.2±1.6] ng/mL and (29.4±2.9) mAU / mL, P < 0.05] in patients with cirrhosis, or [4.3±0.4) ng / mL and (29.1±3.0) mAU / mL, P<0.05] in patients with hepatitis B or [(3.2±0.4) ng / mL and (26.7±3.2) mAU / mL, P<0.05] in healthy persons; serum Hsp90 α and PIVKA-Ⅱ levels in 55 survivals were (44.4±4.4) ng / mL and (701.3±62.3) mAU / mL, respectively, which were significantly lower than [(78.3±5.2) ng / mL and (959.2±92.2) mAU / mL, P < 0.05] in 57 dead; univariate analysis showed that extrahepatic metastasis, tumor cell differentiation, Child-Pugh classification, TNM staging, and serum HSP90α and PIVKA-II levels were significantly different in survivals and dead, and the multivariate Logistic regression analysis showed that extrahepatic metastasis, low tumor differentiation, Child-Pugh class C, TNM III-IV staging, as well as serum high HSP90α and PIVKA-II levels were the independent risk factors for poor three-year survival rate (P<0.05); the results of ROC curve analysis showed that the AUC of serum HSP90α and PIVKA-II combination for predicting three-year survival were 0.929, significantly higher by anyone alone (the AUC were 0.814 and 0.836, respectively, P<0.05). Conclusion Serum HSP90α and PIVKA-II levels are closely related to the outcomes of patients with HCC after TACE therapy, and the increased serum levels of the two parameters hints poor prognosis of patients with HCC, which should deal with appropriately in clinical practice.

Key words: Hepatocellular carcinoma, Heat shock protein 90α, Protein-induced by vitamin K antagonist-II, Prognosis