The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection
The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection
复制标题
DOI：
10.1245/s10434-021-10704-9
复制
发表时间：
2021-09-06
影响因子：
3.7
通讯作者：
Ikegami, Toru
中科院分区：
文献类型：
--
作者：
Yanagaki, Mitsuru;Haruki, Koichiro;Ikegami, Toru
营养状况评估对癌症患者至关重要，因为营养状况差与预后差相关;然而，快速转换蛋白（RTP），如前白蛋白，转铁蛋白和视黄醇结合蛋白对肝细胞癌（HCC）预后的影响尚未得到充分研究。因此，我们研究了RTPs在肝癌根治性切除术后的预后意义。方法本研究纳入了2011年1月至2018年12月期间因HCC接受择期肝切除术的150例患者。将前白蛋白、转铁蛋白和视黄醇结合蛋白水平分为两组（高vs.低）; RTP评分（0-3）计算为每次RTP测量值的总和（高= 0;低= 1）。我们回顾性研究了RTP评分与无病生存期和总生存期之间的关系。结果多因素分析显示，高RTP评分（P = 0.022），存在肌肉减少症（P = 0.001），III期或更高（P = 0.005）是无病生存的独立预测因子，而高RTP评分（P < 0.001）、肌肉减少症（P = 0.017）和III期或更高分期（P = 0.012）是总生存率的独立预测因素。在RTP评分高的患者中，阳性B和C型肝炎病毒感染、15 min时高吲哚菁绿色（ICG（R15））、Child-Pugh分级B、低分化癌和术后腹水比RTP评分低的患者更常见。结论术前RTP评分可作为肝癌患者肝切除术后的一个预后指标，提示RTP在评估肿瘤患者营养状况中具有重要作用。
Background Nutritional status assessment is essential in cancer patients because a poor nutritional status has been associated with poor outcomes; however, the impact of rapid turnover proteins (RTPs), such as prealbumin, transferrin, and retinol-binding protein, on the outcomes of hepatocellular carcinoma (HCC) has not been well-investigated. We therefore examined the prognostic significance of RTPs in patients with HCC after curative resection. Methods This study included 150 patients who underwent elective hepatic resection for HCC between January 2011 and December 2018. The prealbumin, transferrin, and retinol-binding protein levels were classified into two groups (high vs. low); the RTP score (0-3) was calculated as the sum of each RTP measurement (high = 0; low = 1). We retrospectively investigated the relationship between the RTP score and disease-free and overall survival. Results Multivariate analysis showed that a high RTP score (P = 0.022), presence of sarcopenia (P = 0.001), and stage III or higher (P = 0.005) were independent predictors of disease-free survival, while a high RTP score (P < 0.001), presence of sarcopenia (P = 0.017), and stage III or higher (P = 0.012) were independent predictors of overall survival. In patients with high RTP scores, positive hepatitis B and C viral infection, high indocyanine green (ICG) at 15 min (ICG(R15)), Child-Pugh grade B, poorly differentiated carcinoma, and postoperative ascites were more common than in patients with low RTP scores. Conclusion The preoperative RTP score may be a prognostic factor in patients with hepatocellular carcinoma after hepatic resection, suggesting an important role of RTP in the assessment of nutritional status in cancer patients.