Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan.
Department of Viral Hepatitis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
PLoS One. 2020 Oct 21;15(10):e0241002. doi: 10.1371/journal.pone.0241002. eCollection 2020.
We examined serum kynurenine levels in patients with chronic hepatitis C virus infection, and the relationship between serum kynurenine and prognosis in patients with hepatocellular carcinoma (HCC) and chronic hepatitis C.
We retrospectively analyzed 604 patients with HCC diagnosed between January 1999 and December 2015, and 288 patients without HCC who were seen at the National Hospital Organization Nagasaki Medical Center between October 2014 and November 2017. The association between serum kynurenine and prognosis was evaluated using the Cox's proportional hazards regression analysis.
Patients with HCC had significantly higher values of serum kynurenine than patients without HCC (median: 557.1 vs. 464.2 ng/mL, p<0.001). Five-year survival rates of HCC patients with serum kynurenine ≥900 (n = 65), 600-899 (n = 194), and <600 ng/mL (n = 345) were 30.6%, 47.4%, and 61.4%, respectively (p = 0.001, log-rank test). Multivariate analysis identified serum kynurenine as an independent predictor for prognosis of HCC patients. The hazard ratio of serum kynurenine ≥900, and 600-899 compared with serum kynurenine <600 ng/mL were 1.91 (p<0.001) and 1.37 (p = 0.015), respectively.
A high level of serum kynurenine correlated with poor prognosis of HCC. Serum kynurenine levels may be a novel biomarker to predict the prognosis of patients with HCC. The development of drugs that inhibit kynurenine production is expected to help improve the prognosis of patients with HCC.
我们检测了慢性丙型肝炎病毒感染患者的血清犬尿氨酸水平，并研究了血清犬尿氨酸与肝细胞癌（HCC）和慢性丙型肝炎患者预后的关系。
我们回顾性分析了 1999 年 1 月至 2015 年 12 月期间诊断的 604 例 HCC 患者和 2014 年 10 月至 2017 年 11 月期间在日本长崎医疗中心就诊的 288 例无 HCC 患者。采用 Cox 比例风险回归分析评估血清犬尿氨酸与预后的关系。
与无 HCC 患者相比，HCC 患者的血清犬尿氨酸水平显著升高（中位数：557.1 与 464.2ng/mL，p<0.001）。血清犬尿氨酸水平≥900ng/mL（n=65）、600-899ng/mL（n=194）和<600ng/mL（n=345）的 HCC 患者 5 年生存率分别为 30.6%、47.4%和 61.4%（p=0.001，对数秩检验）。多变量分析确定血清犬尿氨酸是 HCC 患者预后的独立预测因子。血清犬尿氨酸水平≥900ng/mL 和 600-899ng/mL 与血清犬尿氨酸<600ng/mL 相比，风险比分别为 1.91（p<0.001）和 1.37（p=0.015）。
高水平的血清犬尿氨酸与 HCC 的不良预后相关。血清犬尿氨酸水平可能是预测 HCC 患者预后的一种新的生物标志物。开发抑制犬尿氨酸生成的药物有望改善 HCC 患者的预后。
