Zhejiang University School of Medicine, Hangzhou, China.
Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China.
BMC Cancer. 2024 Aug 23;24(1):1042. doi: 10.1186/s12885-024-12808-3.
Chitinase-3 like-protein-1 (CHI3L1) is a member of the mammalian chitinase-like proteins and elevated serum CHI3L1 level has been proved to be associated with poor prognosis in hepatocellular carcinoma (HCC). This study aimed to investigate the relationship between serum CHI3L1 levels and body composition parameters in patients with HCC after liver transplantation (LT).
This retrospective study enrolled 200 patients after LT for HCC. Blood samples were collected and serum concentrations of CHI3L1 were measured by enzyme-linked immunosorbent assay. Computer tomography (CT) were used to estimate skeletal muscle and adipose tissue mass. Spearman's rank correlation test was performed to assess associations between serum CHI3L1 levels and these body composition parameters. A Cox proportional-hazards regression model was performed to identify independent prognostic factors. Overall survival (OS) and recurrence-free survival (RFS) curves were constructed using the Kaplan-Meier method and compared by the log-rank test.
Total 71 patients (35.5%) were diagnosed with myosteatosis according to skeletal muscle radiation attenuation (SMRA). The 5-year OS rates were 66.9% in non-myosteatosis group, significantly higher than 49.5% in myosteatosis group (p = 0.025), while the RFS of myosteatosis group (5-year RFS: 52.6%) or non-myosteatosis group (5-year RFS: 42.0%) shown no significant difference (p = 0.068). The serum CHI3L1 level were significantly negative correlated with SMRA (r = -0.3, p < 0.001). Interestingly, in patients with myosteatosis, Kaplan-Meier analysis revealed that elevated serum CHI3L1 levels were associated with worse OS (p < 0.001) and RFS (p = 0.047). However, in patients without myosteatosis, Kaplan-Meier analysis found elevated serum CHI3L1 levels were not associated with OS (p = 0.070) or RFS (p = 0.104).
Elevated CHI3L1 was negatively correlated with SMRA, and predicted poorer prognosis in Chinese population after LT for HCC, especially in those patients with concomitant myosteatosis. Monitoring serum CHI3L1 can predict prognosis and effectively guide individual nutrition intervention.
壳三糖酶蛋白-1（CHI3L1）是哺乳动物几丁质酶样蛋白家族的一员，已有研究证实血清 CHI3L1 水平升高与肝细胞癌（HCC）患者预后不良相关。本研究旨在探讨肝移植（LT）后 HCC 患者血清 CHI3L1 水平与身体成分参数之间的关系。
本回顾性研究纳入了 200 例 LT 后 HCC 患者。采集血样，通过酶联免疫吸附试验（ELISA）检测血清 CHI3L1 浓度。采用计算机断层扫描（CT）估计骨骼肌和脂肪组织质量。采用 Spearman 秩相关检验评估血清 CHI3L1 水平与这些身体成分参数之间的相关性。采用 Cox 比例风险回归模型确定独立的预后因素。采用 Kaplan-Meier 法绘制总生存（OS）和无复发生存（RFS）曲线，并用对数秩检验进行比较。
根据骨骼肌辐射衰减（SMRA），共有 71 例（35.5%）患者被诊断为肌少症。非肌少症组的 5 年 OS 率为 66.9%，显著高于肌少症组的 49.5%（p=0.025），而肌少症组（5 年 RFS：52.6%）或非肌少症组（5 年 RFS：42.0%）的 RFS 无显著差异（p=0.068）。血清 CHI3L1 水平与 SMRA 呈显著负相关（r=-0.3，p<0.001）。有趣的是，在肌少症患者中，Kaplan-Meier 分析显示，血清 CHI3L1 水平升高与 OS 较差（p<0.001）和 RFS 较短（p=0.047）相关。然而，在非肌少症患者中，Kaplan-Meier 分析发现血清 CHI3L1 水平升高与 OS 无关（p=0.070）或 RFS 无关（p=0.104）。
CHI3L1 水平升高与 SMRA 呈负相关，可预测中国 LT 后 HCC 患者的预后不良，尤其在合并肌少症的患者中。监测血清 CHI3L1 水平可以预测预后，并有效指导个体化营养干预。
