Rekik Samia, Guyot Erwan, Bhais Mohannad, Ajavon Yves, Grando Véronique, Bourcier Valérie, Nkontchou Gisèle, Nahon Pierre, Sellier Nicolas, Seror Olivier, Ganne-Carrie Nathalie, Nault Jean-Charles
APHP, Hôpitaux universitaires Paris - Seine Saint-Denis, Jean Verdier, Liver Unit, Bondy, France.
APHP, Hôpitaux universitaires Paris - Seine Saint-Denis, Jean Verdier, Biochemistry Department, Bondy, France.
Dig Liver Dis. 2016 Sep;48(9):1088-92. doi: 10.1016/j.dld.2016.06.005. Epub 2016 Jun 15.
Prognostic biomarkers are needed in a heterogeneous population of patients with intermediate hepatocellular carcinoma (HCC) treated by transarterial (chemo)embolization. We aimed to validate the prognostic value of serum CRP levels and the STATE score, combining CRP, albumin and tumor burden.
All cirrhotic patients with HCC treated by a first transarterial (chemo)embolization (2007-2013) in our institution were included. Overall survival was assessed using the Kaplan-Meier method, log rank, univariate and multivariate Cox analyses.
Among 157 patients included, 87% were men, 86% had Child Pugh A. Etiologies of liver disease included alcohol (57%), hepatitis C (32%), hepatitis B (11%) and/or metabolic syndrome (32%); 89% of patients were classified BCLC B. 33% of the patients had a CRP >1mg/dl and 33% a STATE score conferring poor prognosis (<18). Patients with CRP <1mg/dl had better overall survival than patients with CRP >1mg/dl (20 vs. 8 months, P=0.00186). Median overall survival was 6.73 months for patients with a STATE score <18 vs. 22.23 months for patients with STATE-score ≥18 (P=0.0002). In multivariate analysis, a STATE score <18 was independently associated with increased mortality (HR: 2.06 (CI95%: 1.28-3.34), P=0.0031).
In cirrhotic patients with HCC who underwent transarterial treatment, serum CRP level and STATE score at baseline can predict overall survival.
对于接受经动脉（化疗）栓塞治疗的异质性中期肝细胞癌（HCC）患者群体，需要预后生物标志物。我们旨在验证血清CRP水平和结合CRP、白蛋白及肿瘤负荷的STATE评分的预后价值。
纳入在我们机构接受首次经动脉（化疗）栓塞治疗（2007 - 2013年）的所有肝硬化HCC患者。使用Kaplan - Meier法、对数秩检验、单因素和多因素Cox分析评估总生存期。
在纳入的157例患者中，87%为男性，86%为Child Pugh A级。肝病病因包括酒精性（57%）、丙型肝炎（32%）、乙型肝炎（11%）和/或代谢综合征（32%）；89%的患者被分类为BCLC B期。33%的患者CRP>1mg/dl，33%的患者STATE评分提示预后不良（<18）。CRP<1mg/dl的患者总生存期优于CRP>1mg/dl的患者（20个月对8个月，P = 0.00186）。STATE评分<18的患者中位总生存期为6.73个月，而STATE评分≥18的患者为22.23个月（P = 0.0002）。在多因素分析中，STATE评分<18与死亡率增加独立相关（HR：2.06（CI95%：1.28 - 3.34），P = 0.0031）。
在接受经动脉治疗的肝硬化HCC患者中，基线时的血清CRP水平和STATE评分可预测总生存期。
