Changes in the Levels of HSP70,PTN,and PIVKA-Ⅱ before and after High-intensity Focused Ultrasound Therapy in Patients with Primary He-patic Carcinoma and Their Predictive Efficacy for Early Recurrence

LIU Hongtao; WANG Dongdong; CHEN Ying

doi:10.3969/j.issn.1002-3429.2024.05.013

Abstract：Objective To investigate the changes in the levels of heat shock protein 70(HSP70),pleiotropic growth factor(PTN),and abnormal prothrombinogenⅡ(PIVKA-Ⅱ)in patients with primary hepatic carcinoma(PHC)before and after high-intensity focused ultrasound(HIFU)therapy,as well as their impact on early recurrence and predictive efficacy.Methods A total of 120 patients with PHC treated from January 2021 to January 2023 were selected,followed by HIFU ther-apy and divided into the recurrence group(n=26)and the non-recurrence group(n=94)according to whether they had re-currence at 6 months after surgery.Clinical data,serum levels of HSP70,PTN,and PIVKA-Ⅱbefore and after treatment,as well as their changes(ΔHSP70,ΔPTN,ΔPIVKA-Ⅱ values),were compared between the two groups.The correlation be-tween ΔHSP70,ΔPTN,ΔPIVKA-Ⅱ and early recurrence after HIFU therapy was analyzed,and the predictive efficacy was evaluated.Results After treatment,the levels of serum HSP70,PTN,and PIVKA-Ⅱin the two groups decreased compared with those before treatment(P＜0.05).The levels of serum HSP70,PTN,and PIVKA-Ⅱin the recurrence group before and after treatment were higher than those in the non-recurrence group(P＜0.01).The ΔHSP70,ΔPTN,and ΔPIVKA-Ⅱvalues in the recurrence group were lower than those in the non-recurrence group(P＜0.01).Spearman correlation analysis showed that before treatment,serum HSP70,PTN,and PIVKA-Ⅱ were positively correlated with tumor diameter and CNLC stage,and negatively correlated with differentiation degree(P＜0.01).Multivariate Logistic regression analysis showed that before and after adjusting for tumor diameter,CNLC stage,and differentiation degree factors,both serum ΔHSP70,ΔPTN,andΔPIVKA-Ⅱ levels were independently associated with early recurrence of PHC patients after HIFU therapy(P＜0.01).The area under the receiver operating characteristic(ROC)curve(AUC)of serum ΔHSP70,ΔPTN,and ΔPIVKA-Ⅱ values for predicting early recurrence of PHC patients after HIFU therapy was 0.916(95%CI:0.851,0.958),with a sensitivity of 0.923 and a specificity of 0.872,which was superior to predictions of the three indicators alone.Conclusion The changes in the levels of HSP70,PTN,and PIVKA-Ⅱbefore and after HIFU treatment in patients with PHC are independently associ-ated with early recurrence,and the combined predictive efficacy is high.