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摘要：
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摘要：目的 探究Wnt1蛋白（Wnt1 protein，Wnt1）/β-连接蛋白（β-catenin）信号通路
相关蛋白对肝细胞癌（hepatocellular carcnoma，HCC）肝动脉化疗栓塞术（transcatheter
arterial chemoembolization，TACE）治疗效果的预测价值。方法 选取2022年1月1日至2023年3月
31日于达州市中心医院行TACE治疗的95例HCC患者为研究对象，采用免疫组织化学法
检测病灶组织与周围正常组织Wnt/β-catenin信号通路相关蛋白（Wnt1蛋白、β-catenin
蛋白）的相对表达水平。根据TACE治疗效果将患者分为缓解组（23例）和非缓解组
（72例），比较两组患者治疗前病灶组织Wnt1蛋白和β-catenin蛋白的相对表达水平
以及血清常规肿瘤标志物 [细胞角蛋白19（cytokeratin 19，CK19）、甲胎蛋白（alpha
fetoprotein，AFP）、高尔基膜蛋白73（golgi protein 73，GP73）] 水平。采用受试者
工作特征（receiver operating characteristic，ROC）曲线分析上述指标对HCC患者TACE
治疗效果的预测价值。结果 与周围正常组织比较，病灶组织Wnt1蛋白（2.35 ± 0.57
比1.08 ± 0.32；t = 18.937，P ＜ 0.001）、β-catenin蛋白（3.19 ± 0.72比1.75 ± 0.36；t =
17.436，P ＜ 0.001）表达水平显著升高。缓解组患者治疗前病灶组织Wnt1蛋白（1.91 ±
0.35比2.49 ± 0.56）和β-catenin蛋白（2.67 ± 0.51比3.36 ± 0.70）相对表达水平以及血清
CK19 [（116.37 ± 30.28）μg/L比（176.42 ± 45.61）μg/L]、AFP [（75.92 ± 22.49）μg/L
比（106.71 ± 30.67）μg/L]、GP73 [（123.85 ± 29.65）μg/L比（174.59 ± 35.18）μg/L] 水
平均显著低于非缓解组（P均＜ 0.05）。ROC曲线分析表明，Wnt1蛋白 + β-catenin蛋白 +
CK19 + AFP + GP73的ROC曲线下面积为0.940，显著大于CK19 + AFP + GP73及Wnt1
蛋白、β-catenin蛋白单独预测的曲线下面积（z = 2.229、3.145、3.229，P = 0.026、
0.013、0.009）。结论 HCC病灶组织Wnt1蛋白和β-catenin蛋白表达水平显著高于周围正
常组织。病灶组织Wnt1蛋白、β-catenin蛋白联合CK19、AFP、GP73水平检测对TACE
治疗HCC的疗效具有一定预测价值。
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Abstract: Objective To investigate the predictive value of Wnt protein (Wnt1) / β-catenin
signaling pathway related protein on the therapeutic efficacy of transcatheter arterial
chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). Methods
A total of 95 HCC patients who underwent TACE treatment in Dazhou Central Hospital from
January 1st, 2022 to March 31st, 2023 were selected. The relative expression levels of Wnt/
β-catenin signaling pathway-related proteins (Wnt1 protein and β-catenin protein) in tumor
tissue and surrounding normal tissue were detected by immunohistochemistry. The patients
were divided into remission group (23 cases) and non-remission group (72 cases) according to
the effect of TACE. The relative expression levels of Wnt1 and β-catenin in tumor tissue and
levels of routine serum tumor markers [cytokeratin 19 (CK19), alpha fetoprotein (AFP), golgi
protein 73 (GP73)] were compared between the two groups. Receiver operating characteristic
(ROC) curve was used to analyze the predictive value of the above indicators on the efficacy
of TACE in HCC patients. Results The relative expression levels of Wnt1 protein (2.35 ± 0.57
vs. 1.08 ± 0.32; t = 18.937, P ＜ 0.001) and β-catenin protein (3.19 ± 0.72 vs. 1.75 ± 0.36; t =
17.436, P ＜ 0.001) in the lesion tissues were significantly higher than those in the surrounding
normal tissues. The relative expression levels of Wnt1 protein (1.91 ± 0.35 vs. 2.49 ± 0.56) and
β-catenin protein (2.67 ± 0.51 vs. 3.36 ± 0.70), as well as the levels of serum CK19 [(116.37 ±
30.28) μg/L vs. (176.42 ± 45.61) μg/L], AFP [(75.92 ± 22.49) μg/L vs. (106.71 ± 30.67) μg/L],
and GP73 [(123.85 ± 29.65) μg/L vs. (174.59 ± 35.18) μg/L] in the lesion tissues of patients
in the remission group were significantly lower than those in the non-remission group before
treatment (all P ＜ 0.05). ROC analysis showed that the area under the ROC curve of Wnt1
protein + β-catenin protein + CK19 + AFP + GP73 was 0.940, which was significantly larger
than the area under the ROC curve of CK19 + AFP + GP73 and Wnt1 protein and β-catenin protein
alone (z = 2.229, 3.145, 3.229; P = 0.026, 0.013, 0.009). Conclusions The expression levels of
Wnt1 and β-catenin in HCC lesion tissue were significantly higher than those in surrounding normal
tissue. The expression levels of Wnt1 and β-catenin in HCC lesion tissue combined with levels of
CK19, AFP and GP73 had certain predictive value for the efficacy of TACE in HCC treatment.
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