Carr Brian I, Giannelli Gianluigi, Guerra Vito, Giannini Edoardo G, Farinati Fabio, Rapaccini Gian Ludovico, Marco Maria Di, Zoli Marco, Caturelli Eugenio, Masotto Alberto, Virdone Roberto, Sacco Rodolfo, Trevisani Franco
1 Izmir Biomedicine and Genome Institute (iBG), Dokuz Eylul University, Izmir, Turkey.
2 National Institute of Digestive Diseases, IRCCS Saverio de Bellis, Castellana Grotte, Italy.
Int J Biol Markers. 2018 Nov;33(4):423-431. doi: 10.1177/1724600818776838. Epub 2018 Jun 6.
: Hepatocellular carcinoma is associated with several chronic liver diseases, especially chronic hepatitis B virus, hepatitis C virus, and alcoholism. It is increasingly appreciated that obesity/metabolic syndrome is also associated with chronic liver disease and subsequent hepatocellular carcinoma.
: We retrospectively investigated the serum lipid profiles in a large hepatocellular carcinoma cohort, associated predominantly with the hepatitis B virus, hepatitis C virus, alcohol or nonalcoholic steatohepatitis. The cohort was examined both as a whole, as well as stratified by etiology.
: We found significant associations between parameters of hepatocellular carcinoma biology such as maximum tumor diameter, portal vein thrombosis, tumor multifocality or alpha-fetoprotein levels and individual lipid components, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and body mass index. In a final multiple linear regression model considering all lipid variables together, only high-density lipoprotein cholesterol was significantly associated with the tumor Tumor Aggressiveness Index. High-density lipoprotein cholesterol was found to have a statistically higher hazard ratio for death than low high-density lipoprotein cholesterol levels (Cox). On examination by etiological group, alpha-fetoprotein levels were significantly higher in patients with hepatitis C virus compared to those with alcohol or nonalcoholic steatohepatitis, but maximum tumor diameter, tumor multifocality and portal vein thrombosis were similar across etiological groups. Nonalcoholic steatohepatitis patients had significantly less cirrhosis than other groups and hepatitis B virus patients had significantly higher cholesterol and low-density lipoprotein cholesterol levels than hepatitis C virus patients.
: This is the first report, to our knowledge, of a relationship between serum lipid parameters and indices of hepatocellular carcinoma growth, invasion and aggressiveness, as well as with survival.
肝细胞癌与多种慢性肝病相关，尤其是慢性乙型肝炎病毒、丙型肝炎病毒感染以及酗酒。人们越来越认识到肥胖/代谢综合征也与慢性肝病及随后发生的肝细胞癌有关。
我们回顾性研究了一个大型肝细胞癌队列的血清脂质谱，该队列主要与乙型肝炎病毒、丙型肝炎病毒、酒精或非酒精性脂肪性肝炎相关。对整个队列以及按病因分层后的队列进行了检查。
我们发现肝细胞癌生物学参数（如最大肿瘤直径、门静脉血栓形成、肿瘤多灶性或甲胎蛋白水平）与个体脂质成分（包括总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯和体重指数）之间存在显著关联。在一个综合考虑所有脂质变量的最终多元线性回归模型中，只有高密度脂蛋白胆固醇与肿瘤侵袭性指数显著相关。发现高密度脂蛋白胆固醇水平的患者死亡风险比低密度脂蛋白胆固醇水平高的患者具有统计学上更高的风险比（Cox分析）。按病因组检查时，丙型肝炎病毒感染患者的甲胎蛋白水平显著高于酒精性或非酒精性脂肪性肝炎患者，但不同病因组之间的最大肿瘤直径、肿瘤多灶性和门静脉血栓形成情况相似。非酒精性脂肪性肝炎患者的肝硬化程度明显低于其他组，乙型肝炎病毒感染患者的胆固醇和低密度脂蛋白胆固醇水平显著高于丙型肝炎病毒感染患者。
据我们所知，这是首份关于血清脂质参数与肝细胞癌生长、侵袭和侵袭性指标以及生存率之间关系的报告。
