Abstract: Objective: To analyze the relationship between serum circIPO11 level and its clinicopathological features and prognosis in patients with primary liver cancer (PLC).
Methods: From February 2020 to January 2022, 120 PLC patients (case group) and 120 healthy people (control group) were prospective selected by Tianshui First People's Hospital, and the relative expression of circIPO11 in serum of all subjects was determined by real-time fluorescence quantitative PCR.Compare the relative expression of circIPO11 in serum between the control group and the case group, and draw ROC curve to analyze the value of circIPO11 expression in predicting PLC occurrence. The relative expression of circIPO11 in serum of patients with different pathological features in the case group was compared, and the correlation between the expression of circIPO11 and clinicopathological features and prognosis was analyzed. Kaplan-Meier survival analysis and Cox regression model for multivariate prognostic analysis.
Results: The relative expression of serum circIPO11 in case group was higher than that in control group (P< 0.05). The ROC curve showed that the relative expression of serum circIPO11 predicted the AUC(95%CI) of PLC to be 0.883 (0.842-0.925). Compared with PLC patients with different tumor stages, degrees of differentiation, portal vein tumor thrombus, lymph node metastasis and preoperative alpha-fetoprotein level, the difference was statistically significant (all P< 0.05). Point-column correlation showed that the relative expression of serum circIPO11 was positively correlated with portal vein tumor thrombus, lymph node metastasis and preoperative alpha-fetoprotein level in PLC patients (r=0.403,0.298,0.397, P< 0.05). Spearman correlation showed that the relative expression of serum circIPO11 was positively correlated with the tumor stage of PLC patients (r=0.328, P< 0.05) and negatively correlated with the differentiation degree (r=-0.304, P< 0.05).The overall survival rate of 120 patients with PLC was 46.7%(56/120) and the median survival time was 27.5 months (95%CI: 25.8-29.3 months). Kaplan-Meier survival analysis revealed that the median survival times were 29.7 months (95%CI: 27.3-32.2 months) in the low circIPO11 expression group and 25.3 months (95%CI: 22.9-27.7 months) in the high circIPO11 expression group. The 3-year survival rate was significantly higher in the low-expression group compared to the high-expression group (P< 0.05). Multivariate regression analysis showed that tumor stage, differentiation degree, portal vein tumor thrombus, lymph node metastasis, preoperative alpha-fetoprotein level and preoperative circIPO11 expression were independent risk factors for postoperative mortality of PLC patients (all P< 0.05).
Conclusions: circIPO11 is highly expressed in serum of PLC patients, and its expression is related to pathological features such as tumor stage, degree of differentiation, lymph node metastasis and preoperative alpha-fetoprotein level, and the high expression of circIPO11 is a risk factor affecting the survival status of PLC patients after 3 years.

Key words: Primary liver cancer, CircIPO11, Pathological features, Prognosis