A Hepatocellular Carcinoma Aggressiveness Index and Its Relationship to Liver Enzyme Levels
A Hepatocellular Carcinoma Aggressiveness Index and Its Relationship to Liver Enzyme Levels
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DOI：
10.1159/000444394
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发表时间：
2016-01-01
期刊：
影响因子：
3.5
通讯作者：
Guerra, Vito
中科院分区：
文献类型：
--
作者：
Carr, Brian I.;Guerra, Vito
背景：肝细胞癌的预后受肝脏和肿瘤因素的共同影响，二者被认为是相互独立的影响因素。然而，最近的证据表明，潜在的肝脏也有预后信息。目的：探讨肝功能参数与肝细胞癌侵袭性指标之间的可能关系。方法：对一个包含基线临床信息和生存数据的大型肝细胞癌患者数据库进行回顾性研究。结果：分析了756例胆红素正常的肝细胞癌患者血清肝酶与肿瘤最大直径、门静脉侵犯、肿瘤多灶性及血清甲胎蛋白水平4项侵袭性指标之间的关系。酶水平升高与肝细胞癌侵袭性增加之间存在关联。由4个指标构建攻击性指数，并将其表示为得分之和，进而反映3个存活组。在COX模型中，每组的风险比显著不同。结论：标准肝功能参数与肝细胞癌侵袭性之间存在统计学意义上的相关性。构建了一个综合攻击性指数，得到了3个不同生存概率的群体。这些发现支持了潜在肝脏对于肝细胞癌生物学的重要性这一概念。(C)2016年S.Karger AG，巴塞尔
Background: Prognosis in hepatocellular carcinoma (HCC) is influenced by both liver and tumor factors, which have been considered independent influences. However, recent evidence has shown that the underlying liver also has prognostic information. Aims: To investigate possible relationships between liver function parameters and HCC aggressiveness indices. Methods: A large HCC patient database with baseline clinical information and survival data was retrospectively examined. Results: Data on 756 HCC patients with normal bilirubin were examined for a relationship between serum liver enzymes and 4 HCC aggressiveness indices of maximum tumor diameter, portal vein invasion, tumor multifocality or serum alpha-fetoprotein levels. An association was found between elevated enzyme levels and increased HCC aggressiveness. An aggressiveness index was constructed from the 4 indices and expressed as a sum of their scores, which in turn reflected 3 survival groups. In a Cox model, the hazard ratios for each of the groups were significantly different. Conclusions: Statistically significant correlations were found between standard liver function parameters and HCC aggressiveness. A composite aggressiveness index was constructed, yielding 3 groups with different survival probabilities. These findings support the concept of the importance of the underlying liver in relation to HCC biology. (C) 2016 S. Karger AG, Basel