ABSTRACT
Objective To study the expression and significance of Glypican-3 in Budd-Chiari syndrome (BCS) complicated with hepatocellular carcinoma (HCC).Methods The data of 46 patients with BCS complicated with HCC (the BCS + HCC group) treated in The First Affiliated Hospital of Zhengzhou University from January 2007 to December 2016 were analyzed retrospectively.Another 48 patients with HBV-related HCC (the HBV + HCC group) and 43 patients with hepatic cyst (the hepatic cyst group) were randomly selected as the control groups during the same time period.The differencesin positive rates of Glypican-3 in the liver tissues among the three groups were compared.The BCS + HCC group was further divided into the Glypican-3 positive and Glypican-3 negative subgroups according to the expression of Glypican-3.The differences in gender,age,AFP,HbsAg,Child-Pugh classification,tumor number,extrahepatic metastasis,vascular invasion,Edmondson-Steiner grading and BCLC staging between the two subgroups were compared.The survival time of the two subgroups was compared using the Kaplan-Meier method.Results The expression rates of Glypican-3 in the BCS + HCC group,HBV + HCC group and Hepatic Cyst group were 76.1％,70.8％ and 0％,respectively.The levels of Glypican-3 in the BCS + HCC group and the HCC group were significantly higher than that in the hepatic cyst group.The differences were statistically significant (P ＜ 0.05).No statistically significant difference was detected between the BCS + HCC group and the HBV + HCC group (P ＞ 0.05).In the group of patients with BCS + HCC,there was no significant difference in gender,age,AFP,HbsAg,Child-Pugh classification,tumor number and extrahepatic metastasis between the Glypican-3 positive and negative subgroups (P ＞0.05).However,vascular invasion,Edmondson-Steiner grading and BCLC staging in the Glypican-3 positive subgroup were significantly higher than those in the Glypican-3 negative group,(P ＜ 0.05).The 1-year,3-year and 5-year survival rates were 77.1％,51.0％ and 22.8％ in the Glypican-3 positive subgroup,compared with 90.9％,63.6％ and 45.5％ in the Glypican-3 negative subgroup,respectively.There were statistically significant differences between the two groups (P ＜ 0.05).Conclusion Glypican-3 has a stable expression in patients with BCS complicated with HCC,and it is closely related to malignancy of the tumor and prognosis of the patients.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors of Budd-Chiari syndrome (B-CS) complicated with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The clinical data of 30 patients with B-CS complicated with HCC treated in the First Affiliated Hospital of Zhengzhou University from December 2012 to November 2014 were analyzed retrospectively, 106 another patients were selected randomly as control group in the same term. Gender, age, medical history, type of B-CS, hemoglobin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, Child-Pugh classification, portal vein diameter, HBV infection and drinking history were recorded and analyzed between the two groups. Univariate analysis and unconditional Logistic regression model were performed to screen corresponding risk factors. Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each indicator.</p><p><b>RESULTS</b>Univariate analysis showed that there were no statistical differences in gender (χ² =0.001), age (t=0.317), medical history (t=-0.906), type of B-CS (χ² =2.894), ALT (t=-1.581), Child-Pugh classification (Z=-0.777), HBV infection (χ² =0.016) and drinking history (χ² =0.285) between the two groups (all P > 0.05), but the hemoglobin (t=3.370) and albumin (t=2.152) in HCC group were lower and AST (t=-2.425) and portal vein diameter (t=-2.554) were higher than that in the other group, and the differences were statistically significant (all P <0.05). The results of unconditional Logistic regression model analysis indicated that hemoglobin, AST and portal vein diameter were independent risk factors of B-CS complicated with HCC (OR=0.972, 1.015, 1.206; P=0.004, 0.022, 0.012). ROC curve analysis indicated that the AUC of AST, hemoglobin and portal vein diameter was 0.704, 0.324 and 0.624, the predicate value was, in order, AST, portal vein diameter, hemoglobin.</p><p><b>CONCLUSION</b>Hemoglobin, AST and portal vein diameter are independent risk factors of B-CS complicated with HCC.</p>