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目的探讨血清中白细胞介素-6(IL-6)和IL-22对早期乙型病毒性肝炎相关肝细胞癌患者(HBV-HCC)微波消融(MWA)治疗后复发的预测作用。方法收集49例经MWA治疗早期HBVHCC患者术前外周血,应用ELISA检测外周血IL-6与IL-22的含量,同期30例健康人作对照。据x-tile软件计算cut-off值将IL-6和IL-22水平分为高水平组和低水平组,Kaplan-Meier分析两组的无瘤生存期,Log rank检验差异性,Cox回归筛选影响HBV-HCC复发的危险因素。结果 HCC组的IL-6与IL-22水平明显高于对照组(IL-6:13.20(11.87~15.79)pg/ml和10.47(9.50~13.82)pg/ml,P=0.001;IL-22:42.18(34.39~57.44)pg/ml和25.45(22.31~30.12)pg/ml,P<0.001)。Kaplan-Meier分析显示HCC患者术前低IL-6、高总胆红素和低白蛋白水平预示较短无瘤生存期,IL-22对HCC复发的影响差异无统计学意义。Cox回归多因素分析显示低IL-6(≤13.2 pg/ml,HR:3.721,95%CI:1.674~8.272,P=0.001)与低白蛋白水平(≤41.0 g/L,HR:2.085,95%CI:1.101~3.950,P=0.024)是影响肝癌复发的独立危险因素。结论术前IL-6和白蛋白水平可作为MWA治疗HBV-HCC患者预测复发的指标。
Objective To investigate the predictive value of serum interleukin-6 (IL-6) and IL-22 on relapse after microwave ablation (MWA) in patients with early-stage hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) Methods 49 cases of pre-operative peripheral blood from patients with HBV-HBV treated by MWA were collected. The levels of IL-6 and IL-22 in peripheral blood were measured by ELISA. Thirty healthy subjects were used as control. The levels of IL-6 and IL-22 were divided into high-level group and low-level group according to the cut-off value calculated by x-tile software. The Kaplan-Meier analysis was used to analyze the difference of tumor-free survival time, Log rank test and Cox regression Risk factors affecting the recurrence of HBV-HCC. Results The levels of IL-6 and IL-22 in HCC group were significantly higher than those in control group (P = 0.001 for IL-6: 13.20 (11.87-15.79) pg / ml and 10.47 42.18 (34.39 ~ 57.44) pg / ml and 25.45 (22.31 ~ 30.12) pg / ml, P <0.001). Kaplan-Meier analysis showed that preoperative low IL-6, high total bilirubin and low albumin levels in HCC patients predicted shorter tumor-free survival and no significant difference between IL-22 and HCC recurrence. Cox regression multivariate analysis showed that low IL-6 (≤13.2 pg / ml, HR: 3.721, 95% CI: 1.674-8.272, P = 0.001) % CI: 1.101 ~ 3.950, P = 0.024) is an independent risk factor for the recurrence of liver cancer. Conclusions Preoperative IL-6 and albumin levels can be used as predictors of recurrence in patients with HBV-HCC treated with MWA.