Melhorn Philipp, Raderer Markus, Mazal Peter, Berchtold Luzia, Beer Lucian, Kiesewetter Barbara
Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
Department of Pathology, Medical University of Vienna, Vienna, Austria.
J Neuroendocrinol. 2024 Dec;36(12):e13454. doi: 10.1111/jne.13454. Epub 2024 Oct 14.
Abnormal liver blood tests and liver tumor burden are known prognostic factors in neuroendocrine neoplasms (NEN). However, the relationship between biochemical liver parameters and hepatic tumor load is largely unknown in NEN and in high-grade NEN (G3) specifically. The primary objective of this study was to correlate the biochemical parameters and liver tumor volume of patients with neuroendocrine tumors grade 3 (NET G3) or neuroendocrine carcinomas (NEC). We wanted to investigate whether patients with NET G3 with extensive liver involvement had less severely elevated laboratory liver parameters than NEC patients. In total, 46 patients with NEN were included, 31 had NEC and 15 NET G3. All patients had distant metastatic disease, with liver metastases being the most common (n = 39). Both laboratory results and semiautomatic volumetric measurements of liver tumor burden were obtainable for 34 patients at baseline and 26 patients at follow-up. Alkaline phosphatase (AP), gamma-GT (gGT), and lactate dehydrogenase (LDH) increased significantly between the two time periods (p < .01). In a regression model, liver tumor burden significantly affected several blood parameters, for example, increasing AP, gGT, LDH, and aspartate aminotransferase (ASAT) by a factor of 1.02-1.04 per unit increase (1% tumor burden; all p < .001). AP, gGT, and LDH were significantly lower in NET G3 (factor of 0.43-0.68) than in NEC. Here, we found that liver chemistries changed over the NEN disease course, correlated with hepatic tumor burden, and differed by histologic subtype. The current data can potentially guide treatment decisions, for example, with regard to integration of liver-directed therapies.
异常的肝脏血液检查结果和肝脏肿瘤负荷是神经内分泌肿瘤（NEN）已知的预后因素。然而，在NEN中，尤其是在高级别NEN（G3）中，生化肝脏参数与肝脏肿瘤负荷之间的关系很大程度上尚不清楚。本研究的主要目的是将3级神经内分泌肿瘤（NET G3）或神经内分泌癌（NEC）患者的生化参数与肝脏肿瘤体积进行关联。我们想研究肝脏广泛受累的NET G3患者的实验室肝脏参数升高程度是否低于NEC患者。总共纳入了46例NEN患者，其中31例为NEC，15例为NET G3。所有患者均有远处转移疾病，肝转移最为常见（n = 39）。在基线时，34例患者可获得实验室检查结果和肝脏肿瘤负荷的半自动体积测量数据，随访时为26例患者。在两个时间段之间，碱性磷酸酶（AP）、γ-谷氨酰转移酶（gGT）和乳酸脱氢酶（LDH）显著升高（p < 0.01）。在回归模型中，肝脏肿瘤负荷显著影响多个血液参数，例如，每单位增加（1%肿瘤负荷），AP、gGT、LDH和天冬氨酸转氨酶（ASAT）升高1.02 - 1.04倍（所有p < 0.001）。NET G3患者的AP、gGT和LDH显著低于NEC患者（系数为0.43 - 0.68）。在此，我们发现肝脏生化指标在NEN疾病过程中发生变化，与肝脏肿瘤负荷相关，且因组织学亚型而异。目前的数据可能有助于指导治疗决策，例如在肝脏定向治疗的整合方面。
