Sideris Georgios A, Tsaramanidis Savvas, Vyllioti Aikaterini T, Njuguna Njogu
Baystate Medical Center, Department of Radiology, University of Massachusetts Medical School, Springfield, MA 01199, USA.
Radiology Working Group, Society of Junior Doctors, 11527 Athens, Greece.
Cancers (Basel). 2023 Feb 1;15(3):926. doi: 10.3390/cancers15030926.
Branched-chain amino acid (BCAA) supplementation has been linked with favorable outcomes in patients undergoing surgical or palliative treatments for hepatocellular carcinoma (HCC). To date, there has been no systematic review investigating the value of BCAA supplementation in HCC patients undergoing locoregional therapies.
A systematic search of the literature was performed across five databases/registries using a detailed search algorithm according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The search was conducted on March 23, 2022.
Sixteen studies with a total of 1594 patients were analyzed. Most patients were male (64.6%) with a mean age of 68.2 ± 4.1 years, Child-Pugh score A (67.9%) and stage II disease (40.0%). Locoregional therapy consisted of radiofrequency ablation, transarterial chemoembolization or hepatic artery infusion chemotherapy. BCAA supplementation was in the form of BCAA granules or BCAA-enriched nutrient. Most studies reported improved albumin levels, non-protein respiratory quotient and quality of life in the BCAA group. Results pertaining to other outcomes including overall survival, recurrence rate, and Child-Pugh score were variable. Meta-analysis showed significantly higher levels of post-treatment serum albumin in the BCAA group (SMD = 0.54, 95% CI 0.20-0.87) but no significant differences in mortality rate (RR = 0.81, 95% CI: 0.65-1.02) and AST (SMD = -0.13, 95% CI: -0.43-0.18).
BCAA supplementation is associated with higher post-treatment albumin levels. There are currently not sufficient data to support additional benefits. Further studies are needed to elucidate their value.
补充支链氨基酸（BCAA）与接受肝细胞癌（HCC）手术或姑息治疗的患者的良好预后相关。迄今为止，尚未有系统评价研究补充BCAA在接受局部区域治疗的HCC患者中的价值。
根据系统评价和Meta分析的首选报告项目（PRISMA）声明，使用详细的检索算法在五个数据库/注册库中进行文献系统检索。检索于2022年3月23日进行。
分析了16项研究，共1594例患者。大多数患者为男性（64.6%），平均年龄68.2±4.1岁，Child-Pugh评分A（67.9%），疾病分期为II期（40.0%）。局部区域治疗包括射频消融、经动脉化疗栓塞或肝动脉灌注化疗。补充BCAA的形式为BCAA颗粒或富含BCAA的营养物质。大多数研究报告BCAA组的白蛋白水平、非蛋白呼吸商和生活质量有所改善。关于其他结局，包括总生存期、复发率和Child-Pugh评分的结果各不相同。Meta分析显示，BCAA组治疗后血清白蛋白水平显著更高（标准化均数差[SMD]=0.54，95%置信区间[CI]0.20-0.87），但死亡率（风险比[RR]=0.81，95%CI：0.65-1.02）和谷草转氨酶（AST）（SMD=-0.13，95%CI：-0.43-0.18）无显著差异。
补充BCAA与治疗后更高的白蛋白水平相关。目前尚无足够数据支持其他益处。需要进一步研究以阐明其价值。
