Relationship between serum FABP5, SII, and VEGF levels and prognosis in patients with liver cancer

doi:10.3969/j.issn.1004-583X.2026.05.002

Abstract

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

CLC Number:

R735.7

Wang Tianhui, Lyu Hui, Feng Lifei, Chen Yajie. Relationship between serum FABP5, SII, and VEGF levels and prognosis in patients with liver cancer[J]. Clinical Focus, 2026, 41(5): 399-405.

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Figures/Tables 9

References 17

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组别	例数	FABP5(μg/L)	SII	VEGF(ng/L)
观察组	200	14.51±3.41	323.45±31.52	381.52±40.56
对照组	200	7.85±2.86	198.64±25.68	205.64±27.86
t值		21.163	43.414	20.548
P值		<0.01	<0.01	<0.01

组别	例数	FABP5(μg/L)	SII	VEGF(ng/L)
观察组	200	14.51±3.41	323.45±31.52	381.52±40.56
对照组	200	7.85±2.86	198.64±25.68	205.64±27.86
t值		21.163	43.414	20.548
P值		<0.01	<0.01	<0.01

项目	预后不良组(n=94)	预后良好组(n=106)	χ²/t值	P值
年龄(岁)	60.52±9.56	59.86±8.77	0.509	0.611
性别(男/女)	57/37	65/41	0.010	0.921
肝功能Child-Pugh分级[例(%)]
A级 B级	56(59.57) 38(40.43)	77(72.64) 29(27.36)	3.818	0.051
分化程度[例(%)]
低分化	26(27.66)	31(29.25)
中分化	37(39.36)	35(33.02)	0.918	0.632
高分化	31(32.98)	40(37.74)
合并高血压[例(%)]	45(47.87)	41(38.68)	1.718	0.190
合并糖尿病[例(%)]	51(54.26)	60(56.60)	0.111	0.739
肿瘤最大径(cm)	2.86±0.53	2.78±0.61	0.984	0.326
肿瘤数目(个)[例(%)]
≥2 <2	53(56.38) 41(43.62)	66(62.26) 40(37.74)	0.715	0.398
肿瘤TNM分期[例(%)]
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	30(31.91) 64(68.09)	77(72.64) 29(27.36)	33.216	<0.01
病理分型[例(%)]
肝细胞肝癌	34(36.17)	48(45.28)
胆管细胞癌	34(36.17)	28(26.42)	2.546	0.280
混合细胞癌	26(27.66)	30(28.30)
WBC(×10⁹/L)	8.78±1.35	8.61±1.43	0.861	0.390
PLT(×10⁹/L)	138.46±18.67	141.55±19.63	1.137	0.257
Hb(g/L)	208.67±35.46	213.57±32.48	1.020	0.309
ALB(g/L)	49.56±7.11	48.67±7.63	0.850	0.396
AST(U/L)	29.65±5.11	30.52±6.02	1.094	0.275
ALT(U/L)	29.53±6.22	30.11±6.37	0.650	0.517
Cr(μmol/L)	68.56±16.79	71.53±18.62	1.179	0.240
BUN(mmol/L)	4.26±1.02	4.47±1.15	1.359	0.176
UA(μmol/L)	298.55±46.67	310.52±52.41	1.697	0.091
AFP(μg/L)	291.47±40.37	277.65±36.53	2.541	0.012
CEA(μg/L)	13.25±3.47	12.58±4.05	1.248	0.213
PIVKA-Ⅱ(μg/L)	336.55±62.49	315.68±58.64	2.435	0.016
FABP5(μg/L)	17.85±2.68	11.33±2.86	16.572	<0.01
SII	342.56±40.15	291.64±36.45	9.401	<0.01
VEGF(ng/L)	457.68±52.11	316.53±38.49	21.945	<0.01

项目	预后不良组(n=94)	预后良好组(n=106)	χ²/t值	P值
年龄(岁)	60.52±9.56	59.86±8.77	0.509	0.611
性别(男/女)	57/37	65/41	0.010	0.921
肝功能Child-Pugh分级[例(%)]
A级 B级	56(59.57) 38(40.43)	77(72.64) 29(27.36)	3.818	0.051
分化程度[例(%)]
低分化	26(27.66)	31(29.25)
中分化	37(39.36)	35(33.02)	0.918	0.632
高分化	31(32.98)	40(37.74)
合并高血压[例(%)]	45(47.87)	41(38.68)	1.718	0.190
合并糖尿病[例(%)]	51(54.26)	60(56.60)	0.111	0.739
肿瘤最大径(cm)	2.86±0.53	2.78±0.61	0.984	0.326
肿瘤数目(个)[例(%)]
≥2 <2	53(56.38) 41(43.62)	66(62.26) 40(37.74)	0.715	0.398
肿瘤TNM分期[例(%)]
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	30(31.91) 64(68.09)	77(72.64) 29(27.36)	33.216	<0.01
病理分型[例(%)]
肝细胞肝癌	34(36.17)	48(45.28)
胆管细胞癌	34(36.17)	28(26.42)	2.546	0.280
混合细胞癌	26(27.66)	30(28.30)
WBC(×10⁹/L)	8.78±1.35	8.61±1.43	0.861	0.390
PLT(×10⁹/L)	138.46±18.67	141.55±19.63	1.137	0.257
Hb(g/L)	208.67±35.46	213.57±32.48	1.020	0.309
ALB(g/L)	49.56±7.11	48.67±7.63	0.850	0.396
AST(U/L)	29.65±5.11	30.52±6.02	1.094	0.275
ALT(U/L)	29.53±6.22	30.11±6.37	0.650	0.517
Cr(μmol/L)	68.56±16.79	71.53±18.62	1.179	0.240
BUN(mmol/L)	4.26±1.02	4.47±1.15	1.359	0.176
UA(μmol/L)	298.55±46.67	310.52±52.41	1.697	0.091
AFP(μg/L)	291.47±40.37	277.65±36.53	2.541	0.012
CEA(μg/L)	13.25±3.47	12.58±4.05	1.248	0.213
PIVKA-Ⅱ(μg/L)	336.55±62.49	315.68±58.64	2.435	0.016
FABP5(μg/L)	17.85±2.68	11.33±2.86	16.572	<0.01
SII	342.56±40.15	291.64±36.45	9.401	<0.01
VEGF(ng/L)	457.68±52.11	316.53±38.49	21.945	<0.01

组别	例数	FABP5(μg/L)	SII	VEGF(ng/L)
Ⅰ~Ⅱ期	107	13.50±2.61	281.68±38.67	320.45±55.18
Ⅲ~Ⅳ期	93	15.48±3.05	349.56±43.97	429.68±66.54
t值		4.947	11.617	12.688
P值		<0.01	<0.01	<0.01