血清自分泌酶水平预测肝癌肝切除术后肝衰竭的价值。

Utility of serum autotaxin levels for predicting post hepatectomy liver failure in hepatocellular carcinoma.

机构信息

Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2023 Jun;30(6):825-833. doi: 10.1002/jhbp.1278. Epub 2022 Dec 5.

DOI:10.1002/jhbp.1278

PMID:36408692

Abstract

BACKGROUND/PURPOSE: This study aimed to evaluate the usefulness of serum autotaxin, a novel liver fibrosis marker, for predicting post hepatectomy liver failure (PHLF) in patients undergoing hepatectomy for hepatocellular carcinoma (HCC).

METHODS

Autotaxin was measured in sera from 269 patients undergoing hepatectomy for HCC. Correlations between autotaxin level, liver fibrosis stage (METAVIR F0-F4), and PHLF, as assessed by the International Study Group of Liver Surgery criteria, were analyzed.

RESULTS

Median autotaxin concentrations correlated significantly with fibrosis stage (F0, 0.93; F1, 0.96; F2, 1.18; F3, 1.40; and F4, 1.47 mg/l; P < .0001). Autotaxin levels were significantly higher in female patients and hepatitis C virus antibody-positive patients compared with male or antibody-negative patients (P < .0001). PHLF grade ≥ B occurred in 25 patients (9.3%). A PHLF prediction model was constructed from four variables (autotaxin, resection rate, sex, and hepatitis C virus antibody positivity) and gave an area under the receiver operating characteristic curve of 0.8 (95% confidence interval [CI]: 0.69-0.87), which was superior to models based on ALPlat and resection rate (0.75, 95% CI: 0.64-0.83) or indocyanine green retention test and resection rate (0.72, 95% CI: 0.61-0.81).

CONCLUSION

Serum autotaxin has utility for predicting liver fibrosis and PHLF in patients with HCC.

摘要

背景/目的：本研究旨在评估新型肝纤维化标志物血清自分泌酶（autotaxin）预测肝细胞癌（HCC）患者行肝切除术后肝衰竭（PHLF）的价值。

方法

检测 269 例行肝切除术 HCC 患者的血清自分泌酶水平。分析自分泌酶水平与 METAVIR F0-F4 分期和根据国际肝脏外科研究组标准评估的 PHLF 之间的相关性。

结果

自分泌酶浓度的中位数与纤维化分期（F0，0.93；F1，0.96；F2，1.18；F3，1.40；F4，1.47mg/L；P<0.0001）显著相关。与男性或抗体阴性患者相比，女性患者和丙型肝炎病毒抗体阳性患者的自分泌酶水平显著更高（P<0.0001）。25 例（9.3%）患者发生 PHLF 分级≥B。从四个变量（自分泌酶、切除率、性别和丙型肝炎病毒抗体阳性）构建 PHLF 预测模型，其受试者工作特征曲线下面积为 0.8（95%置信区间：0.69-0.87），优于基于 ALPlat 和切除率（0.75，95%置信区间：0.64-0.83）或吲哚菁绿保留试验和切除率（0.72，95%置信区间：0.61-0.81）的模型。