血清内皮细胞蛋白 C 受体作为肝硬化患者生存预测因子。
Serum endocan as a survival predictor for patients with liver cirrhosis.
出版信息
Can J Gastroenterol Hepatol. 2015 Nov-Dec;29(8):427-30. doi: 10.1155/2015/153805.
BACKGROUND
The relationship between endocan expression and outcome in patients with chronic liver disease is not fully understood.
OBJECTIVE
To examine whether serum endocan level is predictive of outcome in patients with liver cirrhosis.
METHODS
A total of 68 patients with liver cirrhosis were enrolled. Outcome predictors were analyzed using the Cox proportional hazards model. The overall survival rates were calculated using the Kaplan-Meier method, and differences were evaluated using the log-rank test.
RESULTS
During the median follow-up period (7.1 years), nine patients had hepatocellular carcinoma (HCC) and 10 patients died. Of the deceased patients, nine died due to hepatic decompensation or associated conditions. No significant factors were found to be predictive of the occurrence of HCC. In contrast, an elevated serum endocan level (≥2.0 ng⁄mL; HR 2.34 [95% CI 1.05 to 7.03]; P=0.037) and high Child-Pugh grade B⁄C (HR 2.65 [95% CI 1.30 to 6.89; P=0.006) were predictive of poor survival. Kaplan-Meier analysis revealed that the respective cumulative survival rates at five and 10 years were 97.1% and 87.4% in patients with serum endocan levels <2.0 ng⁄mL and 85.8% and 64.4% in patients with levels ≥2.0 ng⁄mL (P=0.009), respectively. Moreover, the cumulative survival rates were significantly different among the patient groups divided according to serum endocan level and Child-Pugh grade (P=0.002).
CONCLUSION
These findings suggest that serum endocan level may be a survival predictor for patients with liver cirrhosis.
背景
内参表达与慢性肝病患者预后的关系尚不完全清楚。
目的
探讨血清内参水平是否可预测肝硬化患者的预后。
方法
共纳入 68 例肝硬化患者。采用Cox 比例风险模型分析预后预测因素。采用 Kaplan-Meier 法计算总生存率，采用对数秩检验评估差异。
结果
在中位随访期（7.1 年）内，9 例患者发生肝细胞癌（HCC），10 例患者死亡。死亡患者中，9 例死于肝功能失代偿或相关疾病。未发现有显著意义的因素可预测 HCC 的发生。相反，血清内参水平升高（≥2.0ng/ml；HR 2.34[95%CI 1.05 至 7.03]；P=0.037）和较高的 Child-Pugh 分级 B/C（HR 2.65[95%CI 1.30 至 6.89；P=0.006）与不良生存相关。Kaplan-Meier 分析显示，血清内参水平<2.0ng/ml 的患者 5 年和 10 年的累积生存率分别为 97.1%和 87.4%，水平≥2.0ng/ml 的患者分别为 85.8%和 64.4%（P=0.009）。此外，根据血清内参水平和 Child-Pugh 分级将患者分组后，各组间的累积生存率差异有统计学意义（P=0.002）。
结论
这些发现提示血清内参水平可能是肝硬化患者的生存预测指标。
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