门静脉血栓形成与肝细胞癌炎症标志物。

Portal Vein Thrombosis and Markers of Inflammation in Hepatocellular Carcinoma.

机构信息

Liver Transplant Institute, İnönü University, Bulgurlu Mah, Elazig Yolu 15 km, 44289 Merkez Battalgazi, Malatya, Turkey.

National Institute of Gastroenterology, S. de Bellis Research Hospital, Bari, Italy.

出版信息

J Gastrointest Cancer. 2020 Dec;51(4):1141-1147. doi: 10.1007/s12029-020-00489-7.

DOI:10.1007/s12029-020-00489-7

PMID:32851544

Abstract

BACKGROUND

Macroscopic portal vein thrombosis (PVT) is a major poor prognosis factor in patients with hepatocellular carcinoma (HCC). Inflammation is increasingly recognized to be part of the hepatocarcinogenic process and its markers are also prognostically useful.

AIMS

To examine the relationship of inflammation biomarkers to the presence of PVT and to survival in PVT patients with HCC.

METHODS

A large HCC cohort was examined for the presence of PVT and analyzed retrospectively.

RESULTS

Blood levels of NLR, PLR, ESR, CRP, AFP and GGTP were significantly related to the presence of PVT, but not the Glasgow Index. For patients with low alpha-fetoprotein levels, blood ESR and GGTP levels were also significantly increased in patients with PVT compared with those in patients without PVT. In a Cox regression model, serum GGTP levels had a significantly increased hazard ratio on death (1.52, p = 0.008). Kaplan-Meier analysis showed that PVT patients with low serum GGTP levels had significantly longer survival than PVT patients with high GGTP levels (p = 0.0041).

CONCLUSIONS

Indices of inflammation, especially serum GGTP levels, related significantly to the presence of PVT and to survival in HCC patients with PVT.

摘要

背景

巨块型门静脉血栓（PVT）是肝细胞癌（HCC）患者预后不良的主要因素。炎症越来越被认为是肝癌发生过程的一部分，其标志物也具有预后价值。

目的

探讨炎症生物标志物与 HCC 合并 PVT 患者 PVT 存在及生存的关系。

方法

对大量 HCC 患者进行 PVT 检测，并进行回顾性分析。

结果

NLR、PLR、ESR、CRP、AFP 和 GGTP 的血液水平与 PVT 的存在显著相关，但格拉斯哥指数则不然。对于低甲胎蛋白水平的患者，与无 PVT 患者相比，PVT 患者的血液 ESR 和 GGTP 水平也显著升高。在 Cox 回归模型中，血清 GGTP 水平对死亡的风险比显著升高（1.52，p=0.008）。Kaplan-Meier 分析显示，血清 GGTP 水平低的 PVT 患者的生存时间显著长于 GGTP 水平高的 PVT 患者（p=0.0041）。