作者：张超，戴钰辉，赵婷，袁泽龙

单位：河北北方学院附属第一医院介入科，河北 张家口 075000

Authors: Zhang Chao, Dai Yuhui, Zhao Ting, Yuan Zelong

Unit:  Interventional Department, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China

摘要：

目的  探究血清生长分化因子15（growth differentiation factor 15，GDF15）、细胞因子信号转导抑制因子3（suppressor of cytokine signaling 3, SOCS3）水平与原发性肝癌患者接受经导管动脉栓塞化疗（transcatheter arterial chemoembolization，TACE）预后的关系。方法  选取89例2018年9月至2020年5月在河北北方学院附属第一医院行TACE的原发性肝癌患者作为研究组，治疗3个周期后评估近期疗效，将研究组分为预后良好组（n=54）、预后不良组（n=35），另选取同期健康体检者89例作为对照组。血清GDF15、SOCS3表达水平用酶联免疫吸附法测定，并进行组间比较；用多因素Logistic回归分析患者接受TACE预后的影响因素；受试者操作特征曲线(receiver operating characteristic curve, ROC曲线) 分析血清GDF15、SOCS3水平对预后的评估价值。结果  与对照组相比，研究组血清GDF15水平升高，血清SOCS3水平下降（均P＜0.05）；与预后良好组相比，预后不良组血清GDF15水平升高，血清SOCS3水平降低（均P＜0.05）。血清GDF15为原发性肝癌患者接受TACE预后的独立危险因素，而血清SOCS3为独立保护因素（均P＜0.05）。血清GDF15、SOCS3二者联合评估原发性肝癌患者接受TACE预后的ROC曲线的曲线下面积为0.958，优于血清GDF15、SOCS3各自单独检测（Z_{二者联合-GDF15}=2.074、Z_{二者联合-SOCS3}=2.794，P=0.038、P=0.005）。结论  血清GDF15表达水平较高和血清SOCS3表达水平较低的原发性肝癌患者接受TACE预后较差，血清GDF15、SOCS3为原发性肝癌患者接受TACE预后的影响因素，对患者预后情况有较好的评估价值。

关键词： 生长分化因子15；细胞因子信号转导抑制因子3；原发性肝癌；经导管动脉栓塞化疗；预后

Abstract：

Objective   To investigate the relationship between serum levels of growth differentiation factor 15 (GDF15) and suppressor of cytokine signaling 3 (SOCS3) and the prognosis of primary liver cancer patients treated with transcatheter arterial chemoembolization (TACE). Method  89 patients with primary liver cancer who underwent TACE treatment in the First Affiliated Hospital of Hebei North University from September 2018 to May 2020 were collected as the study group. After three courses of treatment, the short-term efficacy was evaluated. The study group was divided into good prognosis group (n=54) and poor prognosis group (n=35), another 89 healthy subjects were selected as the control group. Enzyme linked immunosorbent assay was applied to detect the expression levels of serum GDF15 and SOCS3, and the differences were compared between groups. Multivariate Logistic regression was applied to analyze the influencing factors of TACE treatment prognosis in patients with primary liver cancer. Receiver operating characteristic curve (ROC curve) was used to evaluate the prognostic value of serum GDF15 and SOCS3 levels. Result  Compared with the control group, the serum GDF15 level in the study group was increased, and serum SOCS3 level was decreased (all P<0.05). Compared with the good prognosis group, serum GDF15 level was increased and serum SOCS3 level was decreased in the poor prognosis group (all P<0.05). Serum GDF15 was an independent risk factor for the prognosis of patients with primary liver cancer treated with TACE, while serum SOCS3 was an independent protective factor (all P<0.05). The area under the ROC curve of the combined evaluation of serum GDF15 and SOCS3 for TACE treatment prognosis in primary liver cancer patients was 0.958, which was superior to the individual detection of serum GDF15 and SOCS3 (Z_{combination-GDF15}=2.074, Z_{combination-SOCS3}=2.794, P=0.038, P=0.005). Conclusion  Patients with primary liver cancer who have high serum GDF15 expression level and low serum SOCS3 expression level have poor prognosis after TACE treatment. Serum GDF15 and SOCS3 are factors that affect the prognosis of TACE treatment in primary liver cancer patients, and have good evaluation value for the prognosis of patients.

Key Words:  Growth differentiation factor 15; Suppressor of cytokine signaling 3; Primary liver cancer; Transcatheter arterial chemoembolization; Prognosis

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