Tong Xue-Cheng, Liu Kai, Huang Ze-Yu, Zhang Xiu-Jun, Xue Yuan
Department of Infectious Diseases, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou 213000, Jiangsu Province, China.
World J Hepatol. 2025 Feb 27;17(2):99092. doi: 10.4254/wjh.v17.i2.99092.
Hepatocellular carcinoma (HCC) surveillance is crucial for patients with compensated cirrhosis (CC) and decompensated cirrhosis (DC). Increasing evidence has revealed a connection between thyroid hormone (TH) and HCC, although this relationship remains contentious. Complements and immunoglobulin (Ig), which serve as surrogates of cirrhosis-associated immune dysfunction, are associated with the severity and outcomes of liver cirrhosis (LC). To date, there is a lack of evidence supporting the recommendation of TH, Ig, and complement tests in patients at high risk of HCC.
To assess the predictive value of TH, Ig, and complements for HCC development.
Data from 142 patients, comprising 72 patients with CC and 70 patients with DC, were analysed as a training set. Among them, 100 patients who underwent complement and Ig tests were considered for internal validation. Logistic regression was employed to identify independent risk factors for HCC development.
The median follow-up duration was 32 (24-37 months) months. The incidence of HCC was significantly higher in the DC group (16/70, 22.9%) compared to the CC group (3/72, 4.2%) (² = 10.698, < 0.01). Patients with DC exhibited lower total tetraiodothyronine (TT4), total triiodothyronine (TT3), free triiodothyronine, complement C3, and C4 (all < 0.01), and higher IgA and IgG (both < 0.01). In both CC and DC patients, TT3 and TT4 positively correlated with alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transpeptidase (GGT). IgG positively correlated with IgM, IgA, ALT, and AST, while it negatively correlated with C3 and C4. Multivariable analysis indicated that age, DC status, and GGT were independent risk factors for HCC development.
The predictive value of TH, Ig, and complements for HCC development is suboptimal. Age, DC, and GGT emerge as more significant factors during HCC surveillance in hepatitis B virus-related LC.
肝细胞癌（HCC）监测对于代偿期肝硬化（CC）和失代偿期肝硬化（DC）患者至关重要。越来越多的证据揭示了甲状腺激素（TH）与HCC之间的联系，尽管这种关系仍存在争议。补体和免疫球蛋白（Ig）作为肝硬化相关免疫功能障碍的替代指标，与肝硬化（LC）的严重程度和预后相关。迄今为止，缺乏证据支持对HCC高危患者进行TH、Ig和补体检测的建议。
评估TH、Ig和补体对HCC发生的预测价值。
分析了142例患者的数据，其中包括72例CC患者和70例DC患者，作为训练集。其中，100例接受补体和Ig检测的患者用于内部验证。采用逻辑回归确定HCC发生的独立危险因素。
中位随访时间为32（24 - 37个月）个月。DC组的HCC发生率（16/70，22.9%）显著高于CC组（3/72，4.2%）（² = 10.698，< 0.01）。DC患者的总甲状腺素（TT4）、总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸、补体C3和C4较低（均< 0.01），而IgA和IgG较高（均< 0.01）。在CC和DC患者中，TT3和TT4均与丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和γ-谷氨酰转肽酶（GGT）呈正相关。IgG与IgM、IgA、ALT和AST呈正相关，而与C3和C4呈负相关。多变量分析表明，年龄、DC状态和GGT是HCC发生的独立危险因素。
TH、Ig和补体对HCC发生的预测价值欠佳。在乙型肝炎病毒相关LC的HCC监测中，年龄、DC和GGT是更重要的因素。
