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S-腺苷-L-甲硫氨酸在不同BCLC分期的HBV相关肝癌患者中的可行性和疗效

Feasibility and Efficacy of S-Adenosyl-L-methionine in Patients with HBV-Related HCC with Different BCLC Stages.

作者信息

Guo Tao, He Yukun, Ma Weijie, Liu Zhisu, Liu Quanyan

机构信息

Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.

出版信息

Gastroenterol Res Pract. 2016;2016:4134053. doi: 10.1155/2016/4134053. Epub 2016 Nov 28.

Abstract

. To understand the feasibility and efficacy of treatment with SAMe in patients with hepatitis B-related HCC with different Barcelona Clinic Liver Cancer (BCLC) stages. . We retrospectively enrolled 697 patients with BCLC early-stage (stages 0A) and advanced-stage (stages BC) HCC who underwent SAMe therapy (354 cases) or no SAMe therapy (343 cases). The baseline characteristics, postoperative recoveries, and 24-month overall survival rates of the patients in the 2 groups were compared. Cox regression model analysis was performed to confirm the independent variables influencing the survival rate. . For patients in the early-stage (BCLC stages ) group, little benefit of SAMe therapy was observed. For advanced-stage (BCLC ) patients, SAMe therapy reduced alanine aminotransferase (ALT) and aspartate transaminase (AST) levels and effectively delayed the recurrence time and enhanced the 24-month survival rate. Cox regression model analysis in the advanced-stage group revealed that treatment with SAMe, preoperative viral load, and Child-Pugh grade were independent variables influencing survival time. . SAMe therapy exhibited protective and therapeutic efficacy for BCLC advanced-stage HBV-related HCC patients. And the efficacy of SAMe therapy should be further explored in randomized prospective clinical trials.

摘要

了解在不同巴塞罗那临床肝癌(BCLC)分期的乙型肝炎相关肝癌患者中使用S-腺苷甲硫氨酸(SAMe)治疗的可行性和疗效。我们回顾性纳入了697例接受SAMe治疗(354例)或未接受SAMe治疗(343例)的BCLC早期(0A期)和晚期(BC期)肝癌患者。比较两组患者的基线特征、术后恢复情况及24个月总生存率。进行Cox回归模型分析以确定影响生存率的独立变量。对于早期(BCLC分期)组患者,未观察到SAMe治疗有明显益处。对于晚期(BCLC)患者,SAMe治疗降低了丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平,有效延迟了复发时间并提高了24个月生存率。晚期组的Cox回归模型分析显示,SAMe治疗、术前病毒载量和Child-Pugh分级是影响生存时间的独立变量。SAMe治疗对BCLC晚期乙型肝炎相关肝癌患者具有保护和治疗作用。SAMe治疗的疗效应在随机前瞻性临床试验中进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e459/5149688/a0ef24ae1c0c/GRP2016-4134053.001.jpg

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