Auxiliary diagnostic and clinical prognostic evaluation value of thymidine kinase 1 determination in hepatocellular cancer

doi:10.3969/j.issn.1673-8640.2021.09.006

Abstract

Abstract:

Objective To investigate the auxiliary diagnostic and clinical prognostic evaluation value of thymidine kinase 1（TK1）determination in hepatocellular cancer（HCC）. Methods A total of 123 newly diagnosed HCC patients（HCC group）,83 other liver disease patients（disease control group） and 97 healthy subjects（healthy control group） were enrolled. Serum TK1,alpha-fetoprotein（AFP） and carbohydrate antigen 19-9（CA19-9）were determined. The general data and clinicopathologic characteristics of HCC patients were collected. HCC patients' serum TK1 levels were determined in 1 week,1 month,3 months and 6 months after operation. HCC recurrence was evaluated and followed up for 12 months. Receiver operating characteristic（ROC） curve analysis was used to evaluate the diagnostic value of different tumor markers in HCC. Kaplan-Meier survival curve and multivariate Cox proportional regression analysis were used to assess the prognosis of HCC patients and the risk factors for HCC recurrence. Results The levels of serum TK1 among HCC,disease control and healthy control groups decreased sequentially（P<0.001）. Serum TK1 levels of HCC patients in TNM stage Ⅲ to Ⅳ were higher than those in stage Ⅰ to Ⅱ（P<0.05）,while there was no statistical significance in serum TK1 levels between HCC patients with different clinicopathologic characteristics（P>0.05）. ROC curve analysis showed that the areas under curves（AUC） of TK1,AFP and CA19-9 for the diagnosis of HCC were 0.798,0.903 and 0.683,respectively. The TK1+AFP combined determination had the highest diagnostic efficiency,and the AUC for diagnosing HCC auxiliarily was 0.922. Kaplan-Meier survival curve analysis showed that the progression-free survival（PFS） of patients with high preoperative serum TK1 level（TK1≥2.00 pmol/L） was shorter than that of patients with low serum TK1 level（TK1<2.00 pmol/L）（P<0.001）. Multivariate Cox proportional regression analysis showed that AFP and TK1 were independent risk factors for predicting HCC recurrence [hazard ratios（HR） were 1.000 and 1.016,and 95% confidence intervals（CI） were 1.000-1.001 and 1.010-1.023,respectively]. Serum TK1 dynamic monitoring results showed that serum TK1 levels in recurrence group were increased 6 months after operation（P<0.05）,and there was no statistical significance in serum TK1 levels in the progression-free group at various time points after operation（P>0.05）. Conclusions Serum TK1 has a certain value in the auxiliary diagnosis and clinical prognostic evaluation of HCC,and it is an independent risk factor for predicting the recurrence of HCC.

Key words: Thymidine kinase 1, Alpha-fetoprotein, Carbohydrate antigen 19-9, Hepatocellular cancer

CLC Number:

Q555

HU Tao, LU Renquan, GUO Lin. Auxiliary diagnostic and clinical prognostic evaluation value of thymidine kinase 1 determination in hepatocellular cancer[J]. Laboratory Medicine, 2021, 36(9): 914-919.

Figures/Tables 8

References 15

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组别	例数	TK1
HCC组	123	2.38（1.38~10.75）^*#
疾病对照组	83	1.50（1.41~1.61）^*
正常对照组	97	1.32（1.27~1.39）

组别	例数	TK1
HCC组	123	2.38（1.38~10.75）^*#
疾病对照组	83	1.50（1.41~1.61）^*
正常对照组	97	1.32（1.27~1.39）

项目	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	Youden指数
TK1	0.798（0.737~0.860）	1.98 pmol/L	55.28	98.97	0.542 5
AFP	0.903（0.864~0.943）	10.7 ng/mL	70.73	97.92	0.686 5
CA19-9	0.683（0.614~0.753）	28.83 ng/mL	28.46	97.92	0.263 8
AFP+TK1	0.922（0.887~0.958）	0.6	78.86	98.96	0.779 2

项目	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	Youden指数
TK1	0.798（0.737~0.860）	1.98 pmol/L	55.28	98.97	0.542 5
AFP	0.903（0.864~0.943）	10.7 ng/mL	70.73	97.92	0.686 5
CA19-9	0.683（0.614~0.753）	28.83 ng/mL	28.46	97.92	0.263 8
AFP+TK1	0.922（0.887~0.958）	0.6	78.86	98.96	0.779 2

病理特征	例数	TK1/（pmol/L）	TK1阳性/ [例（%）]
年龄
<60岁	65	2.33（1.30~10.09）	34（52.3）
≥60岁	58	2.52（1.52~11.42）	34（58.6）
分化程度
高	8	1.71（1.34~4.75）	3（37.5）
中	107	2.29（1.38~9.96）	60（56.1）
低	8	3.19（1.45~8.37）	5（62.5）
TNM分期
Ⅰ~Ⅱ期	68	1.94（1.32~8.90）	34（50.0）
Ⅲ~Ⅳ期	55	2.93（1.61~29.1）^*	34（61.8）
HBsAg^①
阳性	84	3.08（1.40~11.04）	50（59.5）
阴性	39	1.87（1.35~6.33）	18（46.2）
是否合并肝硬化
是	63	2.29（1.34~10.18）	36（57.1）
否	60	2.45（1.45~11.12）	32（53.3）