Cluster analysis of indicators of liver functional and preoperative low branched-chain amino acid tyrosine ration indicate a high risk of early recurrence in analysis of 165 hepatocellular carcinoma patients after initial hepatectomy
Cluster analysis of indicators of liver functional and preoperative low branched-chain amino acid tyrosine ration indicate a high risk of early recurrence in analysis of 165 hepatocellular carcinoma patients after initial hepatectomy
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DOI：
10.1016/j.surg.2011.06.001
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发表时间：
2011-08-01
期刊：
影响因子：
3.8
通讯作者：
Hirata, Koichi
中科院分区：
文献类型：
--
作者：
Nakamura, Yukio;Mizuguchi, Toru;Hirata, Koichi
背景。聚类分析用于将许多预后指标（包括肝功能、肿瘤进展和手术变量）划分为特定的聚类。白蛋白（ALB）、肝细胞生长因子（HGF）和支链氨基酸与酪氨酸比（BTR）可以代表肝脏疾病的严重程度和肝脏储备功能。我们根据每个级别开发了 ALB-BTR 和 HGF-BTR 分类，以查找特定的独特亚组。我们的目的是确定初次肝切除术后预后良好和不良的特定亚组。方法。 2002年至2008年间，对165名患者进行了回顾性分析。肝功能指标，包括BTR、肿瘤相关因素和手术变量，通过Ward标准的聚类分析进行评估。 ALB-BTR 分类根据 ALB（截止值，4.0 g/dL）和 BTR（截止值，6.0）分为 4 组。 HGF-BTR 分类也根据 Tiff（截止值，0.35 ng/mL）和 BTR（截止值，6.0）分为 4 组。通过对数秩检验比较各亚组的预后。结果。聚类分析将多个指标分为5个不同的簇。在每个聚类中，我们使用 ALB-BTR 和 HGF-BTR 分类进一步分析了亚组。 ALB-GI（19.1 +/- 2.4 个月）和 HGF-GIII（29.4 +/- 3.8 个月）的平均无复发生存时间小于其平均总生存时间。结论。聚类分析有助于发现相似和不同的指标。尽管肝功能保存良好，但低 BTR 可以识别肝细胞癌患者切除后的早期复发。 （外科手术，2011 年；150：250-62。）
Background. Cluster analysis is used for dividing many prognostic indicators, including liver function, tumor progression, and operative variables, into specific clusters. The albumin (ALB), hepatocyte growth factor (HGF), and branched chain amino-acid to tyrosine ratio (BTR) may represent the severity of liver disease and function of the hepatic reserve. We developed the ALB-BTR and HGF-BTR classifications depending on each level to find specific unique subgroups. Our aim was to identify specific subgroups destined for favorable and poor prognoses after initial hepatectomy.Methods. Between 2002 and 2008, 165 patients were analyzed retrospectively. Liver function indicators, including BTR, tumor-related factors, and operative variables, were evaluated by cluster analysis with Ward's criterion. The ALB-BTR classification, was divided into 4 groups depending on ALB (cutoff value, 4.0 g/dL) and BTR (cutoff value, 6.0). The HGF-BTR classification was also divided into 4 groups depending on Tiff (cutoff value, 0.35 ng/mL) and BTR (cutoff value, 6.0). The prognoses of the subgroups were compared by the log-rank test.Results. Cluster analysis divided multiple indicators into 5 different clusters. In each cluster, we further analyzed subgroups using the ALB-BTR and HGF-BTR classification. Mean recurrence-free survival times in ALB-GI (19.1 +/- 2.4 months) and HGF-GIII (29.4 +/- 3.8 months) were less than their mean overall survival times.Conclusion. Cluster analysis is useful to find similar and different indicators. Even though liver function, was well preserved, low BTR could identify early recurrence in hepatocellular carcinoma patients after resection. (Surgery 2011;150:250-62.)