肝细胞癌患者血清Dickopff 1水平对TACE治疗后预后的影响

doi:10.3969/j.issn.1672-5069.2020.05.029

Abstract

Abstract: Objective To investigate serum level of dickopff 1 in patients with hepatocellular carcinoma (HCC) and its impact on prognosis after transcatheter arterial chemoembolization (TACE) treatment. Methods 90 patients HCC, 90 healthy persons, 86 patients with chronic hepatitis B (CHB) and 81 patients with hepatitis B cirrhosis were enrolled in this study from January 2016 to January 2018, and all patients with HCC received TACE and followed-up for 24 months. Serum levels of Dickopff-1 and AFP were measured by ELISA. Serum Dickopff-1 levels in patients with different clinical and pathological characteristics were compared. The receiver operating characteristic curve (ROC) was drawn to determine the efficacy of serum Dickopff-1 and AFP in the diagnosis of HCC, and the Kaplan-Meier curve was applied for survival analysis. Results Serum Dickopff-1 and AFP levels in patients with HCC were significantly higher than those in patients with liver cirrhosis or in patients with CHB【(0.8±0.1)ng/ml and (12.3±3.0)ng/ml, P<0.05】 or in healthy persons 【(0.7±0.1)ng/ml and (11.5±2.5)ng/ml, respectively, P<0.05】; serum level of dickopff-1 in patients with HCC reduced after TACE treatment to (1.6±0.6)ng/ml, P<0.05); serum level of dickopff-1 in HCC patients with portal cancer thrombus was higher than that in patients without [(2.9±0.3) ng/ml vs. (2.1±0.5)ng/ml, P<0.05); serum level of dickopff-1 in dead patients was higher than that in survivals [(3.5±0.8) ng/ml vs. (1.2±0.3) ng/ml, P<0.05); the area under the ROC curve (AUC) of serum dickopff-1 or AFP alone in the diagnosis of HCC were 0.860 and 0.618, respectively, which had certain diagnostic value for HCC (Z=6.297, P<0.05) and the combined diagnosis of dickopff-1 and AFP improved the efficacy (AUC=0.892), and the sensitivity, specificity and accuracy of the diagnosis were all the highest; the Kaplan-Meier survival analysis showed that the overall survival of patients with high serum dickopff-1 levels was poorer than that in patients with low serum levels (x²=8.418, P<0.05). Conclusion Serum dickopff-1 levels increase in patients with HCC. The higher the levels of serum dickopff-1 in patients with HCC, the worse the prognosis. It might be used as an indicator of the efficacy and prognosis after TACE treatment in patients with HCC.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Dickopff 1, Prognosis

Lu Bin, Cheng Min.. Serum level of dickopff 1 in patients with hepatocellular carcinoma and its impact on prognosis after TACE treatment[J]. Journal of Practical Hepatology, 2020, 23(5): 719-722.

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Serum level of dickopff 1 in patients with hepatocellular carcinoma and its impact on prognosis after TACE treatment

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