血清SPTINK1 SOCS3预测HCC患者TACE治疗预后的价值

doi:10.3969/j.issn.1006-6233.2026.02.014

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摘要 目的: 分析血清丝氨酸蛋白酶抑制剂因子Kazal1型(SPTINK1)、细胞因子信号传送阻抑物3(SOCS3)预测肝细胞癌(HCC)患者经导管动脉化疗栓塞(TACE)治疗预后的价值。方法: 选取2021年1月~2023年1月福建医科大学附属南平第一医院210例行TACE治疗的HCC患者,TACE治疗后随访2年,根据预后情况分为预后不良组和预后良好组。比较两组一般资料、TACE治疗前后血清SPTINK1、SOCS3水平,计算治疗前后血清SPTINK1、SOCS3水平变化率△SPTINK1、△SOCS3,分析HCC患者TACE治疗预后不良的影响因素,分析△SPTINK1、△SOCS3与预后不良的剂量-反应关系,以△SPTINK1、△SOCS3平均值为界,比较不同△SPTINK1、△SOCS3患者预后不良情况,分析△SPTINK1、△SOCS3预测预后不良的价值。结果: 预后不良组Child-Pugh分级B级、巴塞罗那临床肝癌分期(BCLC)B~C期、肿瘤最大径>7cm、肿瘤数目≥2个、血管侵犯、控制营养状况(CONUT)评分>4分、血清甲胎蛋白(AFP)≥400ng/mL、TACE治疗反应疾病稳定(SD)/疾病进展(PD)患者占比高于预后良好组(P<0.05);预后不良组治疗前、治疗后血清SPTINK1水平高于预后良好组,治疗前、治疗后血清SOCS3水平及△SPTINK1、△SOCS3低于预后良好组(P<0.05);Child-Pugh分级B级、BCLC B~C期、肿瘤最大径>7cm、CONUT评分>4分、血清AFP≥400ng/mL、TACE治疗反应SD/PD均为HCC患者TACE治疗预后不良的独立危险因素,△SPTINK1、△SOCS3为独立保护因素(P<0.05);△SPTINK1、△SOCS3与预后不良存在负相关的剂量-反应关系(P<0.05);△SPTINK1<26.36%、△SOCS3<19.38%的HCC患者TACE治疗预后不良率分别高于△SPTINK1≥26.36%、△SOCS3≥19.38%的患者(P<0.05);△SPTINK1、△SOCS3单独预测HCC患者TACE治疗预后不良的曲线下面积(AUC)分别为0.742、0.732,联合预测的AUC为0.868,△SPTINK1、△SOCS3联合预测的AUC明显大于二者单独预测的AUC(P<0.05)。结论: HCC患者TACE治疗前后血清SPTINK1、SOCS3水平变化率与预后不良存在负相关的剂量-反应关系,且具有预测预后不良发生风险的效能,△SPTINK1、△SOCS3联合能明显提高预测价值。

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	杨平湖
	姚志华
	陈良玺
	吴克姣

关键词 ：肝细胞癌, 经导管动脉化疗栓塞, 丝氨酸蛋白酶抑制剂因子Kazal1型, 细胞因子信号传送阻抑物3

Abstract：Objective: To analyze the value of serum serine protease inhibitor factor Kazal1 (SPTINK1) and suppressors of cytokine signaling 3 (SOCS3) in predicting the prognosis of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods: A total of 210 HCC patients were selected who underwent TACE treatment in Nanping First Hospital Affiliated to Fujian Medical University from January 2021 to January 2023. They were followed up for 2 years after TACE treatment. According to the prognosis, they were divided into a poor prognosis group and a good prognosis group. The general data of the two groups and the levels of serum SPTINK1 and SOCS3 before and after TACE treatment were compared. The changes in serum SPTINK1 and SOCS3 levels before and after treatment were calculated. The influencing factors of poor prognosis in HCC patients after TACE treatment were analyzed. The dose-response relationship between △SPTINK1, △SOCS3 and poor prognosis was analyzed. The mean values of △SPTINK1 and △SOCS3 were used as the boundary to compare the poor prognosis of patients with different △SPTINK1 and △SOCS3. The value of △SPTINK1 and △SOCS3 in predicting poor prognosis was analyzed. Results: The proportion of patients with Child-Pugh grade B, Barcelona clinical liver cancer stage (BCLC) B-C, tumor maximum diameter > 7 cm, tumor number ≥ 2, vascular invasion, control of nutritional status (CONUT) score > 4 scores, serum alpha-fetoprotein (AFP) ≥ 400ng/mL, stable disease (SD)/progressive disease (PD) in TACE treatment response in the poor prognosis group was higher than that in the good prognosis group (P<0.05). The levels of serum SPTINK1 in the poor prognosis group before and after treatment were higher than those in the good prognosis group, and the levels of serum SOCS3, △SPTINK1, and △SOCS3 before and after treatment were lower than those in the good prognosis group (P<0.05). Child-Pugh grade B, BCLC stage B-C, tumor maximum diameter > 7 cm, CONUT score > 4 points, serum AFP ≥ 400ng/mL, TACE treatment response SD/PD were all independent risk factors for poor prognosis of HCC patients after TACE treatment, △SPTINK1 and △SOCS3 were independent protective factors (P<0.05). There was a negative dose-response relationship between △SPTINK1, △SOCS3, and poor prognosis (P<0.05). The poor prognosis rate of TACE in HCC patients with △SPTINK1 < 26.36% and △SOCS3 < 19.38% was higher than that in patients with △SPTINK1 ≥ 26.36% and △SOCS3 ≥ 19.38% (P<0.05). The area under the curve (AUC) of △SPTINK1 and △SOCS3 alone in predicting the poor prognosis of TACE in HCC patients was 0.742 and 0.732, respectively, and the AUC of combined prediction was 0.868. The AUC of △SPTINK1 and △SOCS3 combined prediction was significantly greater than that of the two alone (P<0.05). Conclusion: There is a negative dose-response relationship between the change rate of serum SPTINK1 and SOCS3 levels and poor prognosis in HCC patients before and after TACE treatment, and it has the efficacy of predicting the risk of poor prognosis. The combination of △SPTINK1 and △SOCS3 can significantly improve the predictive value.

Key words： Hepatocellular carcinoma Transcatheter arterial chemoembolization Serine protease inhibitor factor Kazal1 type Suppressors of cytokine signaling 3

基金资助:福建医学科技青年培育项目,(编号:21FBQN2021107)

引用本文:

杨平湖, 姚志华, 陈良玺, 吴克姣. 血清SPTINK1 SOCS3预测HCC患者TACE治疗预后的价值[J]. 河北医学, 2026, 32(2): 266-273.
YANG Pinghu, YAO Zhihua, CHEN Liangxi, et al. The Value of Serum SPTINK1 and SOCS3 in Predicting the Prognosis of TACE Treatment in Patients with Hepatocellular Carcinoma. HeBei Med, 2026, 32(2): 266-273.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2026.02.014 或 http://www.hbyxzzs.cn/CN/Y2026/V32/I2/266

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