Gao Xing-Hui, Zhang Shuang-Shuang, Chen Hao, Wang Kun, Xie Wen, Wang Fu-Bing
Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, People's Republic of China,
Department of Dermatology, Shanghai Skin Disease Hospital, Shanghai 200443, People's Republic of China.
Onco Targets Ther. 2018 Sep 17;11:5917-5924. doi: 10.2147/OTT.S164273. eCollection 2018.
This study aimed to explore serum lipoprotein (a) (Lp(a)) levels and investigate their prognostic value in hepatocellular carcinoma (HCC) patients after curative resection.
One cohort of 102 healthy individuals, one cohort of 172 HCC patients, and one cohort of 171 HCC patients undergoing curative resection were studied to evaluate serum Lp(a) levels and their prognostic significance, using Kaplan-Meier curves and log-rank tests.
The Lp(a) levels in HCC patients were significantly lower than those in healthy individuals. Furthermore, the levels in HCC patients were significantly associated with recurrence. HCC patients were stratified into high Lp(a) (>20 mg/L) and low Lp(a) (≤20 mg/L) groups, using an optimal cutoff point for the Lp(a) of 20 mg/L. Low Lp(a) levels significantly correlated with tumor recurrence and survival time; HCC patients with low Lp(a) levels had higher recurrence rates and shorter survival time than those with high Lp(a) levels; Lp(a) was an independent prognostic factor for relapse-free survival and overall survival, and retained its prognostic value for α-fetoprotein ≤400 ng/mL and tumor size ≤5 cm subgroups in the training and validation cohorts.
Lp(a) was a promising and useful marker for assessing and monitoring recurrence and prognosis of patients with HCC, and improving Lp(a) levels may be a promising therapeutic strategy in HCC patients.
本研究旨在探讨血清脂蛋白(a)[Lp(a)]水平,并研究其在肝细胞癌(HCC)患者根治性切除术后的预后价值。
研究了102名健康个体、172名HCC患者以及171名接受根治性切除的HCC患者队列,采用Kaplan-Meier曲线和对数秩检验评估血清Lp(a)水平及其预后意义。
HCC患者的Lp(a)水平显著低于健康个体。此外,HCC患者的Lp(a)水平与复发显著相关。采用Lp(a)的最佳截断值20mg/L,将HCC患者分为高Lp(a)(>20mg/L)和低Lp(a)(≤20mg/L)组。低Lp(a)水平与肿瘤复发和生存时间显著相关;低Lp(a)水平的HCC患者比高Lp(a)水平的患者具有更高的复发率和更短的生存时间;Lp(a)是无复发生存和总生存的独立预后因素,在训练和验证队列中,对于甲胎蛋白≤400ng/mL和肿瘤大小≤5cm的亚组,Lp(a)保留其预后价值。
Lp(a)是评估和监测HCC患者复发及预后的一个有前景且有用的标志物,提高Lp(a)水平可能是HCC患者一种有前景的治疗策略。