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[Krüppel样锌指蛋白转录因子5异常表达在肝癌诊断及预后中的价值]

[Value of abnormal expression of Krüppel-like zinc-finger protein transcription factor 5 in the diagnosis and prognosis of liver cancer].

作者信息

Sai W L, Wang L, Sun J Y, Yang J L, Yao M, Yao D F

机构信息

Research Center of Clinical Medicine, Medical School of Nantong University, Nantong 226001, China.

Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2021 Aug 20;29(8):781-787. doi: 10.3760/cma.j.cn501113-20200721-00405.

Abstract

To explore the value of Krüppel-like factor 5 (KLF5), a family member of the zinc finger protein transcription factor, in the diagnosis and prognostic evaluation of hepatocellular carcinoma (HCC). Cancerous and non-cancerous tissues were collected from 126 cases after HCC surgery by self-matching method with microarray fabrication. Immunohistochemistry was used to analyze the expression of KLF5, clinicopathological characteristics and prognostic value. The sera of 222 cases with chronic liver disease were collected and their KLF5 levels were quantitatively determined by enzyme-linked immunosorbent assay (ELISA). Simultaneously, 40 normal human sera were used as controls to evaluate the value of abnormal KLF5 in the diagnosis and differentiation of benign and malignant liver diseases. T-test, Z-test and χ (2) test were performed on the data. The positive expression rate of KLF5 in the HCC group was 95.2% (120/126), which was significantly higher than the non-cancerous group 38.9% (49/126; χ (2) = 14.385, < 0.001). KLF5 expression was significantly correlated with TNM stage (stage I 35%, stage II 40%, stage III 74.4%, stage IV 78.1%), tumor size, alpha fetoprotein (AFP) concentration, portal vein embolism, HBV infection and 5-year survival rate. Univariate/multivariate analysis showed that KLF5 high expression was an independent predictor of HCC prognosis. The serum KLF5 level was significantly higher in HCC patients than liver cirrhosis, chronic hepatitis and normal control group ( < 0.001). With the serum KLF5 > 800 ng/ml and AFP > 25 μg/L as limit, the positive rates for HCC diagnosis were 90.48% and 73.81%, respectively, which were lower than the AFP specificity and false positive rate, and was helpful for the differential diagnosis of benign and malignant liver diseases. The overexpression of KLF5 in liver cancer tissues and blood is closely related to the HCC clinical stage and prognosis. Moreover, KLF5 analysis is helpful for HCC diagnosis and differential diagnosis.

摘要

探讨锌指蛋白转录因子家族成员Krüppel样因子5(KLF5)在肝细胞癌(HCC)诊断及预后评估中的价值。采用自身配对法收集126例HCC术后癌组织及癌旁组织制作芯片。采用免疫组化法分析KLF5表达、临床病理特征及预后价值。收集222例慢性肝病患者血清,采用酶联免疫吸附测定(ELISA)定量检测其KLF5水平。同时,以40例正常人血清作为对照,评估KLF5异常在肝脏良恶性疾病诊断及鉴别诊断中的价值。对数据进行t检验、Z检验和χ²检验。HCC组KLF5阳性表达率为95.2%(120/126),显著高于癌旁组的38.9%(49/126;χ² = 14.385,P < 0.001)。KLF5表达与TNM分期(Ⅰ期35%,Ⅱ期40%,Ⅲ期74.4%,Ⅳ期78.1%)、肿瘤大小、甲胎蛋白(AFP)浓度、门静脉栓塞、HBV感染及5年生存率显著相关。单因素/多因素分析显示KLF5高表达是HCC预后的独立预测因素。HCC患者血清KLF5水平显著高于肝硬化、慢性肝炎及正常对照组(P < 0.001)。以血清KLF5 > 800 ng/ml和AFP > 25 μg/L为界值,HCC诊断阳性率分别为90.48%和73.81%,低于AFP特异性及假阳性率,有助于肝脏良恶性疾病的鉴别诊断。KLF5在肝癌组织及血液中的过表达与HCC临床分期及预后密切相关。此外,KLF5分析有助于HCC的诊断及鉴别诊断。

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