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肝癌合并门静脉血栓患者的叶酸水平。

Folate levels in hepatocellular carcinoma patients with portal vein thrombosis.

机构信息

Department of Biomedical and Biotechnological Science, University of Catania, 95123, Catania, Italy.

Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.

出版信息

BMC Gastroenterol. 2020 Nov 10;20(1):375. doi: 10.1186/s12876-020-01525-3.

Abstract

BACKGROUND

Portal vein thrombosis (PVT) occurs frequently in hepatocellular carcinoma (HCC) and is often diagnosed in the course of a routine patient evaluation and surveillance for liver cancer. The purpose of this study is to investigate the relationship between folate status and portal vein thrombosis.

METHODS

HCC with PVT patients were 78, HCC without PVT were 60 and control subjects were 70 randomly selected. We evaluate serum and red blood cellular folate, homocysteine, alpha fetal protein cholesterol, triglycerides, prothrombin time.

RESULTS

HCC patients with PVT showed lower levels of serum folate, respect HCC patients without PVT, with an average difference of 1.6 nmol/l p < 0.01 (95% CI - 2.54 to - 0.66), red cell folate 33.6 nmol/l p < 0.001 (95% CI - 43.64 to - 23.55) and albumin 0.29 g/dl p < 0.001 (95% CI - 0.42 to - 0.15); PVT patients displayed higher levels of bilirubin 0.53 mg/dl p < 0.001 (95% CI 0.23 to 0.78), INR 0.91 p < 0.001 (95% CI 0.72 to 1.09), γGT 7.9 IU/l (95% CI 4.14 to 11.65) and homocysteine 4.6 μmol/l p < 0.05 (95% CI 0.32 to 8.87) CONCLUSION: The low folate concentration and higher levels of homocysteine are associated with the loss of antithrombotic function, and with a more aggressive course of HCC and with a higher change of complications related to portal vein thrombosis.

摘要

背景

门静脉血栓形成(PVT)在肝细胞癌(HCC)中很常见,通常在常规患者评估和肝癌监测过程中诊断。本研究旨在探讨叶酸状态与门静脉血栓形成的关系。

方法

随机选择 78 例伴有 PVT 的 HCC 患者、60 例无 PVT 的 HCC 患者和 70 例对照患者。我们评估了血清和红细胞叶酸、同型半胱氨酸、甲胎蛋白、胆固醇、甘油三酯、凝血酶原时间。

结果

伴有 PVT 的 HCC 患者的血清叶酸水平低于无 PVT 的 HCC 患者,平均差异为 1.6 nmol/L(p < 0.01,95%CI -2.54 至 -0.66),红细胞叶酸 33.6 nmol/L(p < 0.001,95%CI -43.64 至 -23.55)和白蛋白 0.29 g/dl(p < 0.001,95%CI -0.42 至 -0.15);PVT 患者的胆红素水平升高 0.53 mg/dl(p < 0.001,95%CI 0.23 至 0.78),INR 升高 0.91(p < 0.001,95%CI 0.72 至 1.09),γGT 升高 7.9 IU/l(95%CI 4.14 至 11.65),同型半胱氨酸升高 4.6 μmol/l(p < 0.05,95%CI 0.32 至 8.87)。

结论

低叶酸浓度和高同型半胱氨酸水平与抗血栓形成功能丧失有关,与 HCC 更具侵袭性的病程和更高的门静脉血栓形成相关并发症变化有关。

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