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| 血清LAG-3联合ANXA3水平与中晚期肝细胞癌患者仑伐替尼联合TACE治疗疗效的关系研究 |
| Study on the Relationship Between Serum LAG-3 Combined With ANXA3 Levels and the Efficacy of Lenvatinib Combined With TACE in Patients With Intermediate and Advanced Hepatocellular Carcinoma |
| 投稿时间：2024-06-05 修订日期：2024-06-05 |
| DOI： |
| 中文关键词: 肝细胞癌 中晚期 淋巴细胞激活基因-3 膜联蛋白A3 仑伐替尼 经动脉化疗栓塞 疗效 |
| 英文关键词: Hepatocellular carcinoma Intermediate and advanced Lymphocyte-activated gene-3 Annexin A3 Lenvatinib Transcatheter arterial chemoembolization Efficacy |
| 基金项目:江苏省卫健委老年健康科研项目（LK2021015） |
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| 中文摘要: |
| 目的 探讨血清淋巴细胞激活基因-3（LAG-3）联合膜联蛋白A3（ANXA3）与中晚期肝细胞癌（HCC）患者仑伐替尼联合经动脉化疗栓塞（TACE）治疗疗效的关系。方法 选取徐州医科大学附属医院2021年12月—2024年2月收治的147例中晚期HCC患者，根据仑伐替尼联合TACE治疗后是否缓解分为缓解组与未缓解组。检测血清LAG-3、ANXA3水平。通过多因素Logistic回归模型分析中晚期HCC患者经仑伐替尼联合TACE治疗后未缓解的影响因素，受试者工作特征（ROC）曲线分析血清LAG-3联合ANXA3对中晚期HCC患者仑伐替尼联合TACE治疗后未缓解的预测价值。结果 147例中晚期HCC患者经仑伐替尼联合TACE治疗后客观缓解率为36.05%，未缓解率为63.95%。单因素分析显示，未缓解组Child-Pugh分级B级比例、AFP≥400 μg/L比例、低分化比例、巴塞罗那肝癌分期（BCLC）C期、血管侵犯比例和血清LAG-3、ANXA3水平高于缓解组（P＜0.05）。多因素Logistic回归模型分析显示，Child-Pugh分级B级、低分化、BCLC分期C期、血管侵犯和LAG-3、ANXA3水平升高为中晚期HCC患者仑伐替尼联合TACE治疗后未缓解的独立危险因素（P＜0.05）。ROC曲线分析显示，血清LAG-3、ANXA3单独与联合预测中晚期HCC患者仑伐替尼联合TACE治疗后未缓解的曲线下面积为0.758、0.771、0.817，二者联合预测效能最高。结论 血清LAG-3、ANXA3水平升高与中晚期HCC患者治疗后未缓解相关，二者联合检测对预测中晚期HCC患者仑伐替尼联合TACE治疗疗效的价值较高。 |
| 英文摘要: |
| Objective To investigate the relationship between serum lymphocyte-activated gene-3 (LAG-3) combined with annexin?A3 (ANXA3) and the efficacy of lenvatinib combined with transcatheter arterial chemoembolization (TACE) in patients with intermediate and advanced hepatocellular carcinoma (HCC). Methods 147 patients with intermediate and advanced HCC admitted to Affiliated Hospital of Xuzhou Medical University from December 2021 to February 2024 were selected , and they were divided into remission group and non-remission group base on whether the combination of lenvatinib and TACE treatment whether to remission. Serum LAG-3 and ANXA3 levels were measured. The influencing factors of non-remission after treatment with lenvatinib combined with TACE in patients with intermediate and advanced HCC were analyzed by multifactorial logistic regression model, and the predictive value of serum LAG-3 in combination with ANXA3 on non-remission after treatment with lenvatinib combined with TACE in patients with intermediate and advanced HCC was analyzed by the receiver operating characteristic (ROC) curve. Results The objective remission rate of 147 patients with intermediate to advanced HCC treated with lenvatinib in combination with TACE was 36.05%, and the non-remission rate was 63.95%. Univariate analysis showed that, the proportion of Child-Pugh grade B, the proportion of AFP≥400μg/L, the proportion of poor differentiation, Barcelona liver cancer staging (BCLC) stage C, the proportion of vascular invasion and the levels of serum LAG-3 and ANXA3 in non-remission group were higher than those in remission group (P<0.05). Multivariate Logistic regression model analysis showed that, Child-Pugh grade B, poor differentiation, BCLC stage C, vascular invasion and elevated levels of LAG-3 and ANXA3 were independent risk factors for non-remission after lenvatinib combined with TACE in patients with intermediate and advanced HCC (P<0.05). ROC curve analysis showed that the area under the curve of serum LAG-3 and ANXA3 alone and in combination predicted non-remission after lenvatinib combined with TACE treatment in patients with intermediate and advanced HCC was 0.758, 0.771, and 0.817, and the combined prediction of the two has the highest efficacy. Conclusion Elevated serum LAG-3 and ANXA3 levels are associated with non-remission after treatment in patients with intermediate- and advanced-stage HCC, and their combined testing has high value in predicting the efficacy of lumvastatinib combined with TACE in patients with intermediate- and advanced-stage HCC. |
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