Carr Brian I, Guerra Vito
Izmir Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey.
Oncology. 2016;90(4):215-20. doi: 10.1159/000444394. Epub 2016 Mar 15.
Prognosis in hepatocellular carcinoma (HCC) is influenced by both liver and tumor factors, which have been considered independent influences. However, recent evidence has shown that the underlying liver also has prognostic information.
To investigate possible relationships between liver function parameters and HCC aggressiveness indices.
A large HCC patient database with baseline clinical information and survival data was retrospectively examined.
Data on 756 HCC patients with normal bilirubin were examined for a relationship between serum liver enzymes and 4 HCC aggressiveness indices of maximum tumor diameter, portal vein invasion, tumor multifocality or serum alpha-fetoprotein levels. An association was found between elevated enzyme levels and increased HCC aggressiveness. An aggressiveness index was constructed from the 4 indices and expressed as a sum of their scores, which in turn reflected 3 survival groups. In a Cox model, the hazard ratios for each of the groups were significantly different.
Statistically significant correlations were found between standard liver function parameters and HCC aggressiveness. A composite aggressiveness index was constructed, yielding 3 groups with different survival probabilities. These findings support the concept of the importance of the underlying liver in relation to HCC biology.
肝细胞癌（HCC）的预后受肝脏和肿瘤因素的影响，以往认为二者相互独立。然而，最近的证据表明，潜在的肝脏状况也具有预后信息。
研究肝功能参数与HCC侵袭性指标之间的可能关系。
回顾性分析一个包含基线临床信息和生存数据的大型HCC患者数据库。
对756例胆红素正常的HCC患者的数据进行分析，以研究血清肝酶与4项HCC侵袭性指标（最大肿瘤直径、门静脉侵犯、肿瘤多灶性或血清甲胎蛋白水平）之间的关系。发现酶水平升高与HCC侵袭性增加有关。根据这4项指标构建了一个侵袭性指数，以各项指标得分之和表示，该指数进而反映出3个生存组。在Cox模型中，各组的风险比有显著差异。
标准肝功能参数与HCC侵袭性之间存在统计学上的显著相关性。构建了一个综合侵袭性指数，产生了3个具有不同生存概率的组。这些发现支持了潜在肝脏状况对HCC生物学特性具有重要意义这一概念。
