在接受直接抗病毒治疗后，治疗后血清CXCL10水平可对慢性丙型肝炎病毒感染所致代偿期和失代偿期肝硬化患者的生存情况进行分层。

Posttreatment serum CXCL10 level stratifies survival in compensated and decompensated cirrhotic patients due to chronic hepatitis C virus infection after direct-acting antiviral therapy.

作者信息

Suzuki Takanori, Matsuura Kentaro, Tahata Yuki, Hikita Hayato, Sakamori Ryotaro, Kawada Norifumi, Enomoto Nobuyuki, Miki Daiki, Yatsuhashi Hiroshi, Kuroda Hidekatsu, Yamashita Taro, Yoshiji Hitoshi, Kurosaki Masayuki, Mawatari Seiichi, Miyaaki Hisamitsu, Asahina Yasuhiro, Hiasa Yoichi, Mochida Satoshi, Nakamoto Yasunari, Takami Taro, Kodama Takahiro, Tatsumi Tomohide, Takehara Tetsuo

机构信息

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan.

Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

出版信息

J Gastroenterol. 2025 Jul 1. doi: 10.1007/s00535-025-02282-4.

DOI:10.1007/s00535-025-02282-4

PMID:40590976

Abstract

AIM

We investigated the usefulness of serum CXCL10 levels for predicting prognosis in hepatitis C virus (HCV)-infected patients with compensated and decompensated cirrhosis (cLC and dLC) after direct-acting antiviral (DAA) therapy.

METHODS

This nationwide multicenter study enrolled 212 HCV-associated LC patients, consisting of 113 cLC and 99 dLC patients, receiving DAA therapy, who had preserved serum samples. Serum CXCL10 levels were measured at pretreatment (pre-CXCL10) and posttreatment (12 or 24 weeks after the end of treatment: EOT12W or EOT24W) (post-CXCL10). We evaluated the relationship between these levels and liver transplantation (LT)-free overall survival (OS) and clinical outcomes.

RESULTS

During the observational period (median: 37 months), 27 patients developed dLC events and 20 died. The post-CXCL10 levels were significantly higher in dLC than in cLC (P = 0.006) and among patients who died than those who survived (P < 0.001). The cutoff value of serum post-CXCL10 level for discriminating the occurrence of death (345 pg/mL) could predict LT-free OS in groups of all, cLC, and dLC patients (P < 0.001, P = 0.007, and P < 0.001, respectively). Multivariate analysis on factors associated with LT-free OS demonstrated that age (HR 1.076; P = 0.013), Child-Pugh score at EOT12W (HR 1.575; P = 0.009), and serum post-CXCL10 level (HR 1.003; P = 0.001) were independent factors.

CONCLUSIONS

The serum post-CXCL10 level was independently related to survival in HCV-associated LC patients.

摘要

目的

我们研究了血清CXCL10水平对于预测接受直接抗病毒药物（DAA）治疗的丙型肝炎病毒（HCV）感染的代偿期和失代偿期肝硬化（cLC和dLC）患者预后的作用。

方法

这项全国性多中心研究纳入了212例接受DAA治疗且保存了血清样本的HCV相关肝硬化患者，其中包括113例cLC患者和99例dLC患者。在治疗前（pre-CXCL10）和治疗后（治疗结束后12周或24周：EOT12W或EOT24W）（post-CXCL10）测量血清CXCL10水平。我们评估了这些水平与无肝移植总体生存（OS）及临床结局之间的关系。

结果

在观察期（中位数：37个月）内，27例患者发生了失代偿期肝硬化事件，20例死亡。dLC患者的post-CXCL10水平显著高于cLC患者（P = 0.006），死亡患者的该水平高于存活患者（P < 0.001）。用于区分死亡发生的血清post-CXCL10水平的截断值（345 pg/mL）可预测所有患者、cLC患者和dLC患者组的无肝移植OS（分别为P < 0.001、P = 0.007和P < 0.001）。对与无肝移植OS相关因素的多变量分析表明，年龄（HR 1.076；P = 0.013）、EOT12W时的Child-Pugh评分（HR 1.575；P = 0.009）和血清post-CXCL10水平（HR 1.003；P = 0.001）是独立因素。