关键词: 肝肿瘤, 血清脂肪酸结合蛋白5, 系统免疫炎症指数, 血管内皮生长因子, 预后

Abstract:

Objective To investigate the relationship between serum fatty acid binding protein 5 (FABP5), systemic immune inflammatory index (SII), vascular endothelial growth factor (VEGF) levels, and prognosis in patients with liver cancer. Methods A total of 200 patients with liver cancer admitted to Anyang General Hospital and Anyang Cancer Hospital from March 2021 to March 2024 were retrospectively enrolled as the observation group. In addition, 200 patients with cirrhosis or chronic hepatitis during the same period were selected as the control group. Clinical data were collected and serum FABP5, SII, and VEGF levels were compared between the two groups. Patients in the observation group were followed up for 1 year after treatment, and prognostic outcomes were recorded. Patients with metastasis, recurrence, or death were assigned to the poor prognosis group (n=94), whereas patients with stable or improved disease were assigned to the good prognosis group (n=106). Serum FABP5, SII, and VEGF levels were compared between the two prognostic groups. Multivariate Cox regression analysis was used to identify risk factors affecting prognosis in patients with liver cancer. The receiver operating curve (ROC) was used to evaluate the predictive performance of serum FABP5, SII, and VEGF for prognosis in patients with liver cancer. Results Serum FABP5 ([14.51±3.41]μg/L), SII (323.45±31.52), and VEGF ([381.52±40.56] ng/L) levels in the observation group were all higher than those in the control group ([7.85±2.86] μg/L, [198.64±25.68], and [205.64±27.86] ng/L, respectively), with statistically significant differences (P<0.05). The proportion of patients with TNM stage Ⅰ-Ⅱ disease was 72.64% in the good prognosis group, which was higher than 31.91% in the poor prognosis group. Serum alpha-fetoprotein (AFP) ([277.65±36.53]μg/L], PIVKA-Ⅱ ([315.68±58.64]μg/L), FABP5 ([11.33±2.86] μg/L), SII (291.64±36.45), and VEGF ([316.53±38.49] ng/L) levels were lower than those in the poor prognosis group ([291.47±40.37] μg/L, [336.55±62.49] μg/L, [17.85±2.68]μg/L, [342.56±40.15], and [457.68±52.11] ng/L, respectively), with statistically significant differences (P<0.05). Serum FABP5 ([15.48±3.05]μg/L), SII (349.56±43.97), and VEGF ([429.68±66.54] ng/L) levels in patients with TNM stage Ⅲ-Ⅳ disease were significantly higher than those in patients with stage Ⅰ-Ⅱ disease (FABP5 [13.50±2.61]μg/L, SII [281.68±38.67], and VEGF [320.45±55.18] ng/L). In addition, within the TNM stage Ⅰ-Ⅱ and Ⅲ-Ⅳ subgroups, serum FABP5, SII, VEGF, AFP, and PIVKA-Ⅱ levels were all significantly higher in the poor prognosis group than in the good prognosis group, with statistically significant differences (all P<0.05). The area under the curve (AUC) for combined prediction of prognosis using serum FABP5, SII, and VEGF was 0.879, which was higher than the individual AUC values for each marker (0.637, 0.534, and 0.619, respectively). The AUC for combined prediction using serum AFP and PIVKA-Ⅱ was 0.835, indicating better predictive performance for the combined serum FABP5, SII, and VEGF model. Cox regression analysis showed that FABP5≥14.96 μg/L, SII≥308.00, VEGF≥380.72 ng/L, and TNM stage Ⅲ-Ⅳ were risk factors for prognosis in patients with liver cancer (P<0.05). Conclusion Serum FABP5, SII, and VEGF are specifically elevated in patients with liver cancer, and their levels are significantly associated with prognosis.

Key words: liver neoplasms, serum fatty acid binding protein 5, systemic immune inflammation index, vascular endothelial growth factor, prognosis