Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Liver Int. 2022 Mar;42(3):663-673. doi: 10.1111/liv.15100. Epub 2021 Dec 3.
BACKGROUND & AIMS: Epidemiological evidence linking fibroblast growth factor 21 (FGF21) with hepatocellular carcinoma (HCC) prognosis lacked. We aimed to evaluate the associations between serum FGF21 levels and HCC survival in a large prospective cohort.
825 newly diagnosed, previously untreated HCC patients from the Guangdong Liver Cancer Cohort were enrolled between September 2013 and April 2017. Serum FGF21 levels were measured by ELISA. Liver cancer-specific survival (LCSS) and overall survival (OS) were calculated. Multivariable Cox proportional hazards models were performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).
Compared with patients in the lowest tertile of serum FGF21 levels, patients in the highest tertile had inferior survival outcomes. HRs in the fully adjusted models were 1.44 (95% CI: 1.07, 1.94; P = .014) and 1.48 (95% CI: 1.12, 1.97; P = .002) for LCSS and OS, respectively. The associations were not significantly modified by selected metabolic disorder diseases or state such as arterial hypertension, diabetes, dyslipidemia, fatty liver, cirrhosis, and body mass index ≥25.0 kg/m , except for that stronger associations were observed in patients co-occurred more than three metabolic disorder diseases (P = .046 for OS and .151 for LCSS), with an HR of 2.01 (95% CI: 1.04, 3.85; P = .009) for OS and 1.51 (95% CI: 0.73, 3.10; P = .195) for LCSS.
Higher serum FGF21 levels were associated with worse survival in HCC patients, suggesting that serum FGF21 may be used as a novel metabolism-related prognostic biomarker for HCC.
将成纤维细胞生长因子 21（FGF21）与肝细胞癌（HCC）预后联系起来的流行病学证据不足。我们旨在评估大样本前瞻性队列中血清 FGF21 水平与 HCC 生存之间的关联。
2013 年 9 月至 2017 年 4 月期间，共纳入 825 例来自广东肝癌队列的新诊断、未经治疗的 HCC 患者。采用 ELISA 法测定血清 FGF21 水平。计算肝癌特异性生存率（LCSS）和总生存率（OS）。采用多变量 Cox 比例风险模型计算风险比（HRs）和 95%置信区间（CIs）。
与血清 FGF21 水平最低三分位的患者相比，水平最高三分位的患者生存结局较差。完全调整模型中的 HR 分别为 1.44（95%CI：1.07，1.94；P=0.014）和 1.48（95%CI：1.12，1.97；P=0.002），用于 LCSS 和 OS。在选定的代谢紊乱疾病或状态（如动脉高血压、糖尿病、血脂异常、脂肪肝、肝硬化和 BMI≥25.0kg/m 2 ）下，这些关联没有显著改变，但在合并三种以上代谢紊乱疾病的患者中，关联更强（OS 的 P=0.046 和 LCSS 的 P=0.151），HR 为 2.01（95%CI：1.04，3.85；P=0.009）和 1.51（95%CI：0.73，3.10；P=0.195），用于 OS 和 LCSS。
较高的血清 FGF21 水平与 HCC 患者的生存较差相关，表明血清 FGF21 可能作为 HCC 新的代谢相关预后生物标志物。
