Impact of the branched-chain amino acid to tyrosine ratio and branched-chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis
Impact of the branched-chain amino acid to tyrosine ratio and branched-chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis
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DOI：
10.1111/jgh.12954
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发表时间：
2015-09-01
影响因子：
4.1
通讯作者：
Yama, Tsuyoki
中科院分区：
文献类型：
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作者：
Tada, Toshifumi;Kumada, Takashi;Yama, Tsuyoki
背景与目的研究表明，支链氨基酸（BCAA）与酪氨酸（BTR）的比值是反映肝功能的一个有用指标，BCAA治疗可降低肝细胞癌（HCC）的发病率。然而，还没有足够的研究BTR和BCAA治疗肝癌的初步治疗后的效果之间的关系。我们调查了BTR和BCAA治疗对HCC患者生存率的影响。MethodsA共315例HCC患者接受BCAA治疗（n=66）或未接受BCAA治疗（n=249）;其中，66例使用倾向评分匹配从每组中选出。分析了肝脏相关死亡的生存率。结果在未接受BCAA治疗的患者中（n=249），与生存相关因素的多变量分析表明，低BTR（4.4）与肝癌患者的不良预后独立相关（风险比，1.880; 95%置信区间，1.125-3.143; P=0.016）。此外，在通过倾向评分匹配选择的患者中（n=132），多变量分析表明BCAA治疗与HCC患者的良好预后独立相关（风险比，0.524; 95%置信区间，0.282-0.973; P=0.041）。BTR与survival.ConclusionsIntervention包括BCAA治疗改善了HCC患者与未经治疗的对照组的生存率，无论BTR如何。此外，低BTR与未接受BCAA治疗的患者预后不良相关。
Background and AimIt has been reported that the branched-chain amino acid (BCAA) to tyrosine ratio (BTR) is a useful indicator of liver function and BCAA therapy is associated with a decreased incidence of hepatocellular carcinoma (HCC). However, there has not been sufficient research on the relationship between BTR and the effects of BCAA therapy after initial treatment of HCC. We investigated the impact of BTR and BCAA therapy on survival in patients with HCC.MethodsA total of 315 patients with HCC who were treated (n=66) or not treated (n=249) with BCAA were enrolled; of these, 66 were selected from each group using propensity score matching. Survival from liver-related mortality was analyzed.ResultsIn patients who did not receive BCAA therapy (n=249), multivariate analysis for factors associated with survival indicated that low BTR (4.4) was independently associated with poor prognosis in patients with HCC (hazard ratio, 1.880; 95% confidence interval, 1.125-3.143; P=0.016). In addition, among patients selected by propensity score matching (n=132), multivariate analysis indicated that BCAA therapy was independently associated with good prognosis in patients with HCC (hazard ratio, 0.524; 95% confidence interval, 0.282-0.973; P=0.041). BTR was not significantly associated with survival.ConclusionsIntervention involving BCAA therapy improved survival in patients with HCCversus untreated controls, regardless of BTR. In addition, low BTR was associated with poor prognosis in patients who did not receive BCAA therapy.