High serum fibroblast growth factor 21 is associated with inferior hepatocellular carcinoma survival: A prospective cohort study
High serum fibroblast growth factor 21 is associated with inferior hepatocellular carcinoma survival: A prospective cohort study
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高血清成纤维细胞生长因子21与下肝细胞癌生存率相关：一项前瞻性队列研究
DOI：
10.1111/liv.15100
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发表时间：
2021-12-03
影响因子：
6.7
通讯作者：
Zhu, Hui-lian
中科院分区：
文献类型：
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作者：
Liu, Zhao-yan;Luo, Yan;Zhu, Hui-lian
背景与目的目前尚缺乏将成纤维细胞生长因子21(FGF21)与肝细胞癌预后联系起来的流行病学证据。我们的目标是在一个大的前瞻性队列中评估血清FGF21水平与肝细胞癌存活率之间的关系。方法收集2013年9月至2017年4月广东省肝癌队列中825例新诊断、未经治疗的肝细胞癌患者。采用双抗体夹心法测定血清FGF21水平。计算肝癌特异性生存率(LCS)和总生存率(OS)。采用多变量Cox比例风险模型计算危险比(HR)和95%可信区间(CI)。结果与血清FGF21水平最低的患者相比，血清FGF21水平最高的患者的生存结局较差。在完全调整的模型中，LCS和OS的小时数分别为1.44(95%CI：1.07，1.94；P趋势=.014)和1.48(95%CI：1.12，1.97；P-趋势=.002)。某些代谢紊乱疾病或状态，如动脉高血压、糖尿病、血脂异常、脂肪肝、肝硬变和体重指数=25.0 kg/m(2)，这些相关性并没有显著改变，除了观察到同时发生三种以上代谢紊乱疾病的患者更强的相关性(P-交互作用=0.046对于OS和0.151对于LCS)，OS的HR为2.01(95%CI：1.04，3.85；P-趋势=0.009)；P-趋势=.195)。结论血清FGF21水平升高与肝细胞癌患者的生存期相关，提示血清FGF21可作为一种新的肝细胞癌代谢相关预后指标。
Background & Aims Epidemiological evidence linking fibroblast growth factor 21 (FGF21) with hepatocellular carcinoma (HCC) prognosis lacked. We aimed to evaluate the associations between serum FGF21 levels and HCC survival in a large prospective cohort. Methods 825 newly diagnosed, previously untreated HCC patients from the Guangdong Liver Cancer Cohort were enrolled between September 2013 and April 2017. Serum FGF21 levels were measured by ELISA. Liver cancer-specific survival (LCSS) and overall survival (OS) were calculated. Multivariable Cox proportional hazards models were performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results Compared with patients in the lowest tertile of serum FGF21 levels, patients in the highest tertile had inferior survival outcomes. HRs in the fully adjusted models were 1.44 (95% CI: 1.07, 1.94; P-trend = .014) and 1.48 (95% CI: 1.12, 1.97; P-trend = .002) for LCSS and OS, respectively. The associations were not significantly modified by selected metabolic disorder diseases or state such as arterial hypertension, diabetes, dyslipidemia, fatty liver, cirrhosis, and body mass index >= 25.0 kg/m(2), except for that stronger associations were observed in patients co-occurred more than three metabolic disorder diseases (P-interaction = .046 for OS and .151 for LCSS), with an HR of 2.01 (95% CI: 1.04, 3.85; P-trend = .009) for OS and 1.51 (95% CI: 0.73, 3.10; P-trend = .195) for LCSS. Conclusions Higher serum FGF21 levels were associated with worse survival in HCC patients, suggesting that serum FGF21 may be used as a novel metabolism-related prognostic biomarker for HCC.