中文摘要：

目的探讨细胞外基质蛋白-1（extracellular matrix protein 1，ECM1）在肝细胞癌（hepatocellular carcinoma，HCC）患者术前血清中的表达水平与肝癌临床病理特征及生存预后间的关系。方法应用酶联免疫吸附法测定HCC患者及健康体检者血清中ECM1表达水平，分析血清ECM1表达水平与临床病理特征及生存预后间的关系。结果117例HCC患者及53例正常对照血清ECM1中位表达浓度分别为166．39、108．06pg/ml，差异有统计学意义（Z=-7．805，P〈0．001）。血清ECM1浓度与肿瘤大小（Z=-3．454，P=0．001）、肿瘤结节数（Z=-2．201，P=0．028）、血管侵犯（Z=-4．685，P〈0．001）和TNM分级（Z=-4．610，P〈0．001）有关。ECM1低表达组患者（180pg／ml）的总生存率和无瘤生存率均明显高于高表达组（〉180pg／ml）。应用Cox回归模型进行单因素和多因素分析均表明血清中ECM1水平是影响肝癌患者生存预后的一个独立危险因素。结论血清ECM1表达水平与肝细胞癌患者术后复发和生存预后密切相关，有可能成为肝癌术后复发的预测指标。

英文摘要：

Objective Toevaluate the prognostic significance of preoperative serum extracellular matrix protein 1 （ ECM1 ） levels in patients with hepatocellular carcinoma （HCC）. Methods Preoperative serum levels of ECM1 were detected by enzyme-linked immunosorbent assay （ELISA） in 117 HCC patients and 53 healthy volunteers. Correlations to the clinicopathological characteristics and patients＇ survival were analyzed. Results ECM1 were detected in all the samples of 117 HCC patients and 53 healthy volunteers, the median serum ECM1 level in HCC patients was significantly higher than that in healthy volunteers （ 166. 39 vs 108. 06 pg/ml, Z = - 7. 805, P 〈 0. 001 ）. Median serum ECM1 levels were significantly higher in patients with invasive phenotypes, such as larger tumor size （ Z = - 3.454, P = 0. 001 ）, multiple nodule （ Z = - 2. 201, P = 0. 028）, vascular invasion （ Z = - 4. 685, P 〈 0. 001 ）, and advanced TNM stage （ Z = -4. 610, P 〈 0. 001 ）. Patients with lower serum ECM1 level （ ≤ 180 pg/ml） have significantly better overall and disease free survival than those with higher levels （ 〉 180 pg/ml）. By Cox proportional-hazard model multivariate analysis, high serum ECM1 level （ 〉 180 pg/ml） was an independent factor for OS and DFS in HCC patients. Conclusions Serum ECM1 levels are significantly correlated to the invasive phenotypes and survival rate. Serum ECM1 level could be used as a predictive marker for HCC recurrence and prognostic factor of HCC patients after surgery.