Toshida Katsuya, Itoh Shinji, Toshima Takeo, Yoshiya Shohei, Bekki Yuki, Izumi Takuma, Iseda Norifumi, Nakayama Yuki, Ishikawa Takuma, Yoshizumi Tomoharu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Fukuoka, 812-8582, Japan.
Surg Today. 2025 Mar;55(3):370-379. doi: 10.1007/s00595-024-02914-x. Epub 2024 Aug 4.
Treatment outcomes are predicted by analyzing peripheral blood markers such as serum lactate dehydrogenase (LDH). We conducted this study to investigate whether serum LDH levels can predict the prognosis of patients treated with atezolizumab plus bevacizumab (ATZ/BEV) therapy for hepatocellular carcinoma (HCC) and whether LDH levels correlate with metabolic changes.
We enrolled 66 HCC patients treated with ATZ/BEV. Based on the change in serum LDH levels before and after treatment, the patients were divided into two groups, and the prognosis of each group was examined. Moreover, the association of LDH levels with tumor metabolism was analyzed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT).
There were 32 patients categorized as the LDH-decrease group. Kaplan-Meier survival analysis indicated worse progression-free survival (PFS) in the LDH-increase group than in the LDH-decrease group (p = 0.0029). Multivariate analysis showed that an increase in the LDH level was an independent risk factor for worse PFS (p = 0.0045). The baseline LDH level correlated significantly with a high maximum standardized uptake value of F-FDG, according to the PET/CT findings. Transcriptomic analyses of specimens resected after ATZ/BEV therapy showed downregulated mitochondria-related pathways.
Serum LDH levels are a potential prognostic marker and an indicator of tumor metabolism.
通过分析外周血标志物如血清乳酸脱氢酶（LDH）来预测治疗结果。我们开展本研究以调查血清LDH水平是否能预测接受阿替利珠单抗联合贝伐珠单抗（ATZ/BEV）治疗的肝细胞癌（HCC）患者的预后，以及LDH水平是否与代谢变化相关。
我们纳入了66例接受ATZ/BEV治疗的HCC患者。根据治疗前后血清LDH水平的变化，将患者分为两组，并检查每组的预后。此外，通过氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）分析LDH水平与肿瘤代谢的关联。
有32例患者被归类为LDH降低组。Kaplan-Meier生存分析表明，LDH升高组的无进展生存期（PFS）比LDH降低组更差（p = 0.0029）。多变量分析显示，LDH水平升高是PFS较差的独立危险因素（p = 0.0045）。根据PET/CT结果，基线LDH水平与F-FDG的高最大标准化摄取值显著相关。对ATZ/BEV治疗后切除的标本进行转录组分析显示线粒体相关通路下调。
血清LDH水平是一种潜在的预后标志物和肿瘤代谢指标。
