肝细胞癌患者肝切除术后1个月外周血RBM15 mRNA及血清GDF-15蛋白变化率对术后复发的预测价值OA

Objective To investigate the predictive value of the change rate of peripheral blood ribonuclee-binding protein 15(RBM15)mRNA and serum growth differentiation factor-15(GDF-15)protein in patients with hepatocellular carcinoma(HCC)one month after hepatectomy for postoperative recurrence.Methods A total of 200 HCC patients admitted to the First People's Hospital of Shuangliu District,Chengdu City,Sichuan Province from January 2018 to June 2022 were selected as the research objects.According to the recurrence of HCC patients after hepatectomy,they were divided into recurrence group and non-recurrence group.Baseline data,peripheral blood RBM15 mRNA and serum GDF-15 protein levels before and 1 month after operation were compared between the two groups.The change rates of RBM15 mRNA in peripheral blood and GDF-15 protein in serum were calculated and compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of recurrence after hepatectomy in HCC patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of peripheral blood RBM15 mRNA and serum GDF-15 protein change rate for recurrence of HCC patients after hepatectomy,and 5-fold cross valida-tion was performed.Results The follow-up deadline was December 30,2024.During the follow-up period,9 patients were lost to follow-up and 70 patients experienced recurrence.The level of serum alpha-fetoprotein(AFP),the degree of tumor differentiation(medium and low),the number of cancer lesions(multiple),and the proportion of diabetes mellitus in the recurrence group were higher than those in the non-recurrence group,and the differences were statistically significant(P<0.05).The levels of RBM15 mRNA in peripheral blood and serum GDF-15 protein in the recurrence group were higher than those in the non-recurrence group before operation and 1 month after operation,and the change rates of RBM15 mRNA in peripheral blood and serum GDF-15 protein in the recurrence group were lower than those in the non-recurrence group,and the differences were statistically significant(P<0.05).After adjusting for AFP,tumor differentiation,number of cancer foci,and diabetes mellitus,the increase in the change rate of peripheral blood RBM15 mRNA and serum GDF-15 protein at 1 month after surgery were protective factors for recurrence of HCC patients after hepatec-tomy(P<0.05).The area under the curve(AUC)of the combination of the change rate of RBM15 mRNA in peripheral blood and GDF-15 protein in serum at 1 month after operation to predict the recurrence of HCC pa-tients after hepatectomy was 0.866,which was greater than the AUC of the two alone(0.766,0.774),and the differences were statistically significant(Z=2.138,2.174,P=0.033,0.030).After 5-fold cross-validation,the correct rate of the combination of peripheral blood RBM15 mRNA and serum GDF-15 protein in predicting the recurrence of HCC patients after hepatectomy was 80.63%.Conclusion The change rate of peripheral blood RBM15 mRNA and serum GDF-15 protein at 1 month after surgery are the influencing factors of recur-rence in HCC patients after hepatectomy.The combination of the two has a high predictive value for recur-rence in HCC patients after hepatectomy,which is conducive to formulating reasonable treatment measures and reducing the risk of postoperative recurrence.