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谷丙转氨酶、谷草转氨酶和天冬氨酸氨基转移酶比值在根治性肝切除术后乙型肝炎相关性肝硬化肝细胞癌中的预后价值

Prognostic Value of ALT, AST, and AAR in Hepatocellular Carcinoma with B-Type Hepatitis-Associated Cirrhosis after Radical Hepatectomy.

作者信息

Zhou Li, Wang Shao-Bin, Chen Shu-Guang, Qu Qiang, Rui Jing-An

出版信息

Clin Lab. 2018 Oct 1;64(10):1739-1747. doi: 10.7754/Clin.Lab.2018.180532.

Abstract

BACKGROUND

Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and AST to ALT ratio (AAR) were shown to be associated with prognosis in some groups of hepatocellular carcinoma (HCC). However, their clinicopathologic and prognostic roles in HCC patients with B-type hepatitis-associated cirrhosis (HBAC) have not been comprehensively investigated. The present study aimed to address the issues.

METHODS

A total of 125 patients with HCC and HBAC after radical hepatectomy were included. The correlations of ALT, AST, and AAR with clinicopathologic parameters, overall/recurrence-free survival, overall/early recurrence, and post-recurrence survival were evaluated using univariate and multivariate analyses.

RESULTS

ALT and AST, which positively correlated with each other, had significant relationships with tumornode-metastasis (TNM) stage and Edmondson-Steiner grade. In univariate analyses, ALT and AST were predictive for early recurrence, overall and recurrence-free survival, while ALT and AST was associated with overall recurrence and post-recurrence survival, respectively. However, only AST was marginally significant in multivariate tests for early recurrence and post-recurrence survival. As for AAR, no significant prognostic relevance was found.

CONCLUSIONS

Our data suggest that ALT and AST, but not AAR, might be potential predictors of post-resectional outcome in HCC with HBAC. These effects might depend on their associations with crucial clinicopathologic variables.

摘要

背景

丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)以及AST与ALT比值(AAR)在某些肝细胞癌(HCC)患者群体中显示与预后相关。然而,它们在乙型肝炎相关性肝硬化(HBAC)的HCC患者中的临床病理及预后作用尚未得到全面研究。本研究旨在解决这些问题。

方法

共纳入125例行根治性肝切除术后的HBAC合并HCC患者。采用单因素和多因素分析评估ALT、AST和AAR与临床病理参数、总生存期/无复发生存期、总复发/早期复发以及复发后生存期的相关性。

结果

ALT和AST相互呈正相关,与肿瘤-淋巴结-转移(TNM)分期及Edmondson-Steiner分级显著相关。在单因素分析中,ALT和AST可预测早期复发、总生存期和无复发生存期,而ALT和AST分别与总复发及复发后生存期相关。然而,在早期复发和复发后生存期的多因素检验中,仅AST具有边缘显著性。至于AAR,未发现显著的预后相关性。

结论

我们的数据表明,ALT和AST而非AAR可能是HBAC合并HCC患者切除术后预后的潜在预测指标。这些作用可能取决于它们与关键临床病理变量的关联。

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