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25-羟维生素 D 缺乏可识别经肝动脉化疗栓塞治疗的肝细胞癌患者的肿瘤应答不良。

25-OH-vitamin D deficiency identifies poor tumor response in hepatocellular carcinoma treated with transarterial chemoembolization.

机构信息

Department of Interventional Oncology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan 2 Road, Guangzhou, 510080, People's Republic of China.

出版信息

Clin Transl Oncol. 2020 Jan;22(1):70-80. doi: 10.1007/s12094-019-02146-3. Epub 2019 Jun 10.

Abstract

PURPOSE

Vitamin D is implicated linked to liver cancer and chronic liver diseases, but its association with tumor response in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) remains unclear. This study aimed to determine whether vitamin D levels influence tumor response in HCC patients treated with TACE.

METHODS

A total of 58 HCC patients undergoing TACE were enrolled in the study. Serum 25-hydroxyvitamin D (25-OHD) levels were determined at baseline and 1 day after TACE using electrochemiluminescence immunoassay. Response to TACE was evaluated after a 4-6 week interval. Univariate and multivariate analyses with Cox regression model were performed to determine the risk factors associated with tumor response. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of baseline 25-OHD levels on tumor response in HCC patients undergoing TACE.

RESULTS

43.1% of HCC patients showed 25-OHD deficiency. Baseline 25-OHD level was associated with liver cirrhosis (P = 0.025), vascular invasion (P = 0.031), Barcelona Clinic Liver Cancer stage (P = 0.002) and an alanine aminotransferase increase after TACE (P = 0.021). Serum 25-OHD level was significantly decreased 1 day after TACE (P = 0.045). Multiple tumor numbers (P = 0.034) and low baseline 25-OHD levels (P = 0.040) were independently correlated with poor tumor response after TACE. ROC curve analysis showed that baseline 25-OHD levels present better predictive performance for OR in those patients, compared with other current clinical test pointers.

CONCLUSION

Our study suggested that 25-OHD deficiency at baseline is a prognostic indicator for a poor tumor response in hepatocellular carcinoma treated with TACE.

摘要

目的

维生素 D 与肝癌和慢性肝病有关,但它与接受经动脉化疗栓塞术(TACE)的肝细胞癌(HCC)患者的肿瘤反应之间的关系尚不清楚。本研究旨在确定维生素 D 水平是否会影响接受 TACE 治疗的 HCC 患者的肿瘤反应。

方法

本研究共纳入 58 例接受 TACE 的 HCC 患者。采用电化学发光免疫分析法在基线和 TACE 后 1 天测定血清 25-羟维生素 D(25-OHD)水平。在 4-6 周间隔后评估 TACE 的反应。使用 Cox 回归模型进行单因素和多因素分析,以确定与肿瘤反应相关的危险因素。进行受试者工作特征(ROC)曲线分析,以评估基线 25-OHD 水平对接受 TACE 的 HCC 患者肿瘤反应的预测性能。

结果

43.1%的 HCC 患者存在 25-OHD 缺乏。基线 25-OHD 水平与肝硬化(P=0.025)、血管侵犯(P=0.031)、巴塞罗那临床肝癌分期(P=0.002)和 TACE 后丙氨酸氨基转移酶升高有关(P=0.021)。TACE 后 1 天血清 25-OHD 水平显著降低(P=0.045)。多发肿瘤数目(P=0.034)和低基线 25-OHD 水平(P=0.040)与 TACE 后肿瘤反应不良独立相关。ROC 曲线分析表明,与其他当前临床检测指标相比,基线 25-OHD 水平对这些患者的 OR 具有更好的预测性能。

结论

本研究表明,基线时 25-OHD 缺乏是 TACE 治疗肝细胞癌患者肿瘤反应不良的预后指标。

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