Lactate Dehydrogenase Is an Important Prognostic Indicator for Hepatocellular Carcinoma after Partial Hepatectomy.
Lactate Dehydrogenase Is an Important Prognostic Indicator for Hepatocellular Carcinoma after Partial Hepatectomy.
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乳酸脱氢酶是部分肝切除术后肝细胞癌的重要预后指标。
DOI：
10.1016/j.tranon.2015.11.006
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发表时间：
2015-12
影响因子：
5
通讯作者：
Liu WL
中科院分区：
文献类型：
--
作者：
Zhang JP;Wang HB;Lin YH;Xu J;Wang J;Wang K;Liu WL
术前血清乳酸脱氢酶（LDH）已被用作索拉非尼治疗或经导管动脉化疗栓塞治疗的肝细胞癌（HCC）患者的预后指标，但其在预测接受根治性切除术的HCC患者的生存率方面的意义尚不明确。共有683例经组织病理学证实的HCC患者入组本研究。采用Kaplan-Meier分析和考克斯比例风险回归模型确定术前血清LDH的预后意义。采用χ2检验或线性回归分析评价术前血清LDH水平与临床病理参数之间的关系。术前血清LDH水平越高，预后越差。多因素考克斯比例风险分析显示，术前血清LDH水平可独立预测总生存率和复发率。术前血清LDH水平升高与血清甲胎蛋白升高、存在B型肝炎表面抗原、肿瘤较大、存在大血管浸润、肿瘤淋巴结转移分期较晚、肿瘤分化较差、Child-Pugh B分级相关。术前血清LDH水平是一种廉价、简单、方便和常规测量的生物标志物，显示出选择具有不良临床结局的高风险患者进行适当治疗策略的潜力。
Preoperative serum lactate dehydrogenase (LDH) has been used as a prognostic indicator for patients with hepatocellular carcinoma (HCC) treated with sorafenib or undergoing transcatheter arterial chemoembolization, but its significance in predicting survival of HCC patients who received curative resection remains undefined. A total of 683 patients with histopathologically confirmed HCC were enrolled in this study. The prognostic significance of preoperative serum LDH was determined by Kaplan-Meier analysis and a Cox proportional hazards regression model. The association between the preoperative serum LDH and clinicopathological parameters was evaluated by the χ2 test or linear regression analysis when appropriate. Higher preoperative serum LDH level was associated with worse prognosis. In a multivariate Cox proportional hazards analysis, the preoperative serum LDH level could predict overall survival and recurrence independently. Higher preoperative serum LDH level is associated with the elevated serum alpha-fetoprotein, the presence of hepatitis B surface antigen, larger tumor size, the presence of macrovascular invasion, the advanced tumor–lymph node–metastasis stage, worse tumor differentiation, and Child-Pugh B. Preoperative serum LDH level was an inexpensive, simple, convenient, and routinely measured biomarker exhibiting a potential to select patients at high risk with poor clinical outcome for appropriate treatment strategies.