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血清 AKR1B10 作为肝细胞癌不良生存的指标。

Serum AKR1B10 as an indicator of unfavorable survival of hepatocellular carcinoma.

机构信息

Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tongzipo Road, Changsha, 410013, Hunan, China.

The Affiliated Hospital of Hunan Research Institute of Traditional Chinese Medicine, 58 Lushan Road, Changsha, 410006, Hunan, China.

出版信息

J Gastroenterol. 2023 Oct;58(10):1030-1042. doi: 10.1007/s00535-023-02011-9. Epub 2023 Jul 27.

DOI:10.1007/s00535-023-02011-9
PMID:37500927
Abstract

BACKGROUND AND AIMS

A large-scale multicenter study validated aldo-keto reductase 1B10 (AKR1B10) as a new serum marker of hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic value of serum AKR1B10 in HCC.

METHODS

273 naïve HCC patients enrolled for serum AKR1B10 tests were followed up for 2 years. Survival and clinical data were collected. Kaplan-Meier survival analysis and log-rank tests were used to estimate correlation of patient survival with serum AKR1B10. Univariate and multivariate COX regression analyses were used to evaluate the prognostic value of serum AKR1B10 level independently or in combination with other clinicopathological factors. α-fetoprotein (AFP) was analyzed in parallel for comparison.

RESULTS

Serum AKR1B10 associated with tumor stage (p = 0.012), size (p = 0.004), primary tumor number (p = 0.019), and Child-Pugh classification (p = 0.003). HCC patients with a high level of serum AKR1B10 (≥ 267.9 pg/ml) had median survival (MS) of 25 months (95% confidence interval [CI] 20.788-29.212) vs. MS of 34 months (CI 28.911-39.089) in patients with normal serum AKR1B10 (p < 0.001). Univariate and multivariate COX regression analyses showed that serum AKR1B10 level was an unfavorable prognostic marker of HCC independently (HR 1.830, 95% CI 1.312-2.552; p < 0.001) or in combination with other clinical factors (HR 1.883, 95% CI 1.264-2.806; p = 0.002), such as TNM stage, tumor size and portal invasion. In the same cohort of HCC patients, AFP exhibited prognostic value at a cut-off of 400 ng/ml, but not at 20 ng/ml and 200 ng/ml.

CONCLUSIONS

Serum AKR1B10 is a new prognostic marker of HCC, better than AFP.

摘要

背景与目的

一项大规模多中心研究验证了醛酮还原酶 1B10(AKR1B10)是肝细胞癌(HCC)的新型血清标志物。本研究旨在评估血清 AKR1B10 对 HCC 的预后价值。

方法

对 273 例接受血清 AKR1B10 检测的初治 HCC 患者进行了 2 年的随访。收集生存和临床数据。采用 Kaplan-Meier 生存分析和对数秩检验评估患者生存与血清 AKR1B10 的相关性。采用单因素和多因素 COX 回归分析评估血清 AKR1B10 水平独立或与其他临床病理因素联合的预后价值。同时分析甲胎蛋白(AFP)进行比较。

结果

血清 AKR1B10 与肿瘤分期(p=0.012)、肿瘤大小(p=0.004)、肿瘤数目(p=0.019)和 Child-Pugh 分级(p=0.003)相关。血清 AKR1B10 水平升高(≥267.9 pg/ml)的 HCC 患者中位生存期(MS)为 25 个月(95%置信区间 [CI] 20.788-29.212),而血清 AKR1B10 水平正常(<267.9 pg/ml)的患者 MS 为 34 个月(CI 28.911-39.089)(p<0.001)。单因素和多因素 COX 回归分析显示,血清 AKR1B10 水平是 HCC 的独立不良预后标志物(HR 1.830,95%CI 1.312-2.552;p<0.001)或与其他临床因素(HR 1.883,95%CI 1.264-2.806;p=0.002)联合,如 TNM 分期、肿瘤大小和门静脉侵犯。在同一批 HCC 患者中,AFP 在截断值为 400 ng/ml 时具有预后价值,但在截断值为 20 ng/ml 和 200 ng/ml 时无预后价值。

结论

血清 AKR1B10 是 HCC 的一种新的预后标志物,优于 AFP。

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