Li Wen-Yuan, Wang Lu-Wen, Dong Jin, Wang Yao
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
World J Hepatol. 2024 Feb 27;16(2):251-263. doi: 10.4254/wjh.v16.i2.251.
The increased expression of G3BP1 was positively correlated with the prognosis of liver failure.
To investigate the effect of G3BP1 on the prognosis of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) after the treatment of artificial liver support system (ALSS).
A total of 244 patients with ALF and ACLF were enrolled in this study. The levels of G3BP1 on admission and at discharge were detected. The validation set of 514 patients was collected to verify the predicted effect of G3BP1 and the viability of prognosis.
This study was shown that lactate dehydrogenase (LDH), alpha-fetoprotein (AFP) and prothrombin time were closely related to the prognosis of patients. After the ALSS treatment, the patient' amount of decreased G3BP1 index in difference of G3BP1 between the value of discharge and admission (difG3BP1) < 0 group had a nearly 10-fold increased risk of progression compared with the amount of increased G3BP1 index. The subgroup analysis showed that the difG3BP1 < 0 group had a higher risk of progression, regardless of model for end-stage liver disease high-risk or low-risk group. At the same time, compared with the inflammatory marks [tumor necrosis factor-α, interleukin (IL)-1β and IL-18], G3BP1 had higher discrimination and was more stable in the model analysis and validation set. When combined with AFP and LDH, concordance index was respectively 0.84 and 0.8 in training and validation cohorts.
This study indicated that G3BP1 could predict the prognosis of ALF or ACLF patients treated with ALSS. The combination of G3BP1, AFP and LDH could accurately evaluate the disease condition and predict the clinical endpoint of patients.
G3BP1表达增加与肝衰竭预后呈正相关。
探讨人工肝支持系统（ALSS）治疗后G3BP1对急性肝衰竭（ALF）和慢加急性肝衰竭（ACLF）预后的影响。
本研究共纳入244例ALF和ACLF患者。检测入院时和出院时的G3BP1水平。收集514例患者的验证集以验证G3BP1的预测效果和预后的可行性。
本研究表明，乳酸脱氢酶（LDH）、甲胎蛋白（AFP）和凝血酶原时间与患者预后密切相关。ALSS治疗后，出院与入院时G3BP1差值（difG3BP1）<0组患者G3BP1指数降低量相比G3BP1指数增加量有近10倍的进展风险增加。亚组分析表明，无论终末期肝病高危或低危组模型如何，difG3BP1<0组有更高的进展风险。同时，与炎症标志物[肿瘤坏死因子-α、白细胞介素（IL）-1β和IL-18]相比，G3BP1在模型分析和验证集中具有更高的辨别力且更稳定。与AFP和LDH联合时，训练和验证队列中的一致性指数分别为0.84和0.8。
本研究表明，G3BP1可预测接受ALSS治疗的ALF或ACLF患者的预后。G3BP1、AFP和LDH联合可准确评估病情并预测患者的临床终点。
