Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Med Oncol. 2014 Jan;31(1):806. doi: 10.1007/s12032-013-0806-2. Epub 2013 Dec 11.
Anemia is a common complication in several types of cancer including hepatocellular carcinoma (HCC). The prognostic potential of hemoglobin (Hb) levels has not yet been investigated in HCC patients. One hundred and ninety-nine patients were prospectively recruited and Hb levels were determined. Hb levels were compared to the stages of liver cirrhosis and HCC stages. The association of the Hb levels and overall survival (OS) was assessed by univariate and multivariate Cox regression models. The relation of Hb levels and OS was further validated in an independent cohort of 87 HCC patients. Hb levels negatively correlated with the stage of liver cirrhosis (model of end stage liver disease score and Child-Pugh stage) and differed between stages of HCC. Low Hb levels (≤ 13 g/dl) were associated with higher mortality in the test [hazard ratio (HR) 2.422, 95 % confidence interval (CI) 1.357-4.322, P = 0.003] as well in the validation cohort (HR 2.486, 95 % CI 1.097-5.632, P = 0.029) in univariate Cox regression model. Low Hb levels were associated with mortality independently from the tumor stage, age, gender and the C-reactive protein levels in a multivariate Cox regression model. Anemia should be considered as a risk factor for mortality in HCC patients.
贫血是包括肝细胞癌（HCC）在内的多种癌症的常见并发症。血红蛋白（Hb）水平在 HCC 患者中的预后潜力尚未得到研究。前瞻性招募了 199 名患者并确定了 Hb 水平。将 Hb 水平与肝硬化和 HCC 分期进行了比较。通过单变量和多变量 Cox 回归模型评估了 Hb 水平与总生存期（OS）的相关性。在 87 名 HCC 患者的独立队列中进一步验证了 Hb 水平与 OS 的关系。Hb 水平与肝硬化的分期呈负相关（终末期肝病模型评分和 Child-Pugh 分期），并且在 HCC 的分期之间存在差异。低 Hb 水平（≤13g/dl）与较高的死亡率相关，在测试中 [风险比（HR）2.422，95％置信区间（CI）1.357-4.322，P=0.003] 以及在验证队列中 [风险比（HR）2.486，95％置信区间（CI）1.097-5.632，P=0.029]，在单变量 Cox 回归模型中。在多变量 Cox 回归模型中，Hb 水平与肿瘤分期、年龄、性别和 C 反应蛋白水平独立相关，是死亡率的一个危险因素。
