Plasma cholesterol and lipoprotein levels in relation to tumor aggressiveness and survival in HCC patients
Plasma cholesterol and lipoprotein levels in relation to tumor aggressiveness and survival in HCC patients
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DOI：
10.1177/1724600818776838
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Trevisani, Franco
中科院分区：
文献类型：
--
作者：
Carr, Brian, I;Giannelli, Gianluigi;Trevisani, Franco
背景和目标：肝细胞癌与几种慢性肝病有关，特别是慢性B型肝炎病毒、丙型肝炎病毒和酒精中毒。越来越多的人认识到肥胖/代谢综合征也与慢性肝病和随后的肝细胞癌有关。研究方法：我们回顾性研究了一个大型肝细胞癌队列的血脂谱，主要与B型肝炎病毒、丙型肝炎病毒、酒精或非酒精性脂肪性肝炎相关。对队列进行整体检查，并按病因分层。结果如下：我们发现肝细胞癌生物学参数如肿瘤最大直径、门静脉血栓形成、肿瘤多灶性或甲胎蛋白水平与个体脂质成分（包括总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯和体重指数）之间存在显著相关性。在考虑所有脂质变量的最终多元线性回归模型中，只有高密度脂蛋白胆固醇与肿瘤侵袭指数显著相关。研究发现高密度脂蛋白胆固醇比低密度脂蛋白胆固醇有统计学上更高的死亡风险比（考克斯）。在按病因分组的检查中，丙型肝炎病毒患者的甲胎蛋白水平显著高于酒精性或非酒精性脂肪性肝炎患者，但最大肿瘤直径、肿瘤多灶性和门静脉血栓形成在病因分组之间相似。非酒精性脂肪性肝炎患者肝硬化明显少于其他组，B型肝炎病毒患者胆固醇和低密度脂蛋白胆固醇水平明显高于丙型肝炎病毒患者。结论：据我们所知，这是第一份报告，血脂参数和肝细胞癌生长，侵袭性和侵略性，以及生存指数之间的关系。
Background and Aims: Hepatocellular carcinoma is associated with several chronic liver diseases, especially chronic hepatitis B virus, hepatitis C virus, and alcoholism. It is increasingly appreciated that obesity/metabolic syndrome is also associated with chronic liver disease and subsequent hepatocellular carcinoma. Methods: We retrospectively investigated the serum lipid profiles in a large hepatocellular carcinoma cohort, associated predominantly with the hepatitis B virus, hepatitis C virus, alcohol or nonalcoholic steatohepatitis. The cohort was examined both as a whole, as well as stratified by etiology. Results: We found significant associations between parameters of hepatocellular carcinoma biology such as maximum tumor diameter, portal vein thrombosis, tumor multifocality or alpha-fetoprotein levels and individual lipid components, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and body mass index. In a final multiple linear regression model considering all lipid variables together, only high-density lipoprotein cholesterol was significantly associated with the tumor Tumor Aggressiveness Index. High-density lipoprotein cholesterol was found to have a statistically higher hazard ratio for death than low high-density lipoprotein cholesterol levels (Cox). On examination by etiological group, alpha-fetoprotein levels were significantly higher in patients with hepatitis C virus compared to those with alcohol or nonalcoholic steatohepatitis, but maximum tumor diameter, tumor multifocality and portal vein thrombosis were similar across etiological groups. Nonalcoholic steatohepatitis patients had significantly less cirrhosis than other groups and hepatitis B virus patients had significantly higher cholesterol and low-density lipoprotein cholesterol levels than hepatitis C virus patients. Conclusions: This is the first report, to our knowledge, of a relationship between serum lipid parameters and indices of hepatocellular carcinoma growth, invasion and aggressiveness, as well as with survival.