Acute-Phase Serum Amyloid A May Predict Microvascular Invasion and Early Tumor Recurrence in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Undergoing Liver Resection.
Xinggang Guo, Wenli Zhang, Jin Du, Rongsuo Tao, Wei Dong, Jian Huang, Jinmin Zhang, Zeya Pan, Weiping Zhou, Xiuli Zhu, Hui Liu, Fuchen Liu
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引用次数: 2
Abstract
Objective: To elucidate the impact of acute-phase protein serum amyloid A (aSAA) on microvascular invasion (MVI) and early recurrence in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
Methods: HBV-related HCC patients (n = 192) undergoing liver resection were included in the study. The protein levels of aSAA were analyzed by immunohistochemical staining in 172 tumor specimens, and further detected via western blotting in HCC and their corresponding portal vein tumor thrombus (PVTT) (n = 20). Cox and logit regression analysis was performed. Exploratory subgroup analysis was used to balance the potential confounders.
Results: HBV-related HCC patients with high aSAA levels tended to have high HBV-DNA loads. Logit and Cox regression analyses revealed high expression of aSAA is an independent risk factor not only for MVI (OR 5.384, 95% CI 2.286-13.301, P < 0.001) but also for early recurrence (HR 6.040, 95% CI 1.970-18.540, P = 0.002), overall recurrence (HR 3.720, 95% CI 2.140-6.450, P < 0.001), and overall survival (HR 4.15, 95% CI 2.380-7.230, P < 0.001). Subgroup analysis showed that the effects of aSAA were consistent across all subgroups examined. Additionally, the aSAA protein level was significantly higher in PVTT than that in its corresponding tumor specimen. A high HBV-DNA level and large tumor size were the independent risk factors for early HCC recurrence in patients with high levels of aSAA.
Conclusions: High expression of aSAA was an independent risk factor for MVI and early tumor recurrence in HBV-related HCC patients after liver resection. The aSAA protein level could thus be a promising biomarker for predicting MVI and early recurrence in these patients.
目的:探讨急性期蛋白血清淀粉样蛋白A (aSAA)对乙型肝炎病毒(HBV)相关性肝细胞癌(HCC)微血管侵袭(MVI)和早期复发的影响。方法:纳入192例行肝切除术的hbv相关HCC患者。应用免疫组化染色分析172例肿瘤标本中aSAA蛋白水平,并应用western blotting检测肝癌及其相应门静脉肿瘤血栓(PVTT) (n = 20)中aSAA蛋白水平。进行Cox和logit回归分析。探索性亚组分析用于平衡潜在的混杂因素。结果:高aSAA水平的hbv相关HCC患者往往具有高HBV-DNA负荷。Logit和Cox回归分析显示,aSAA高表达不仅是MVI的独立危险因素(OR 5.384, 95% CI 2.286 ~ 13.301, P P = 0.002),而且是总复发的独立危险因素(HR 3.720, 95% CI 2.140 ~ 6.450, P P)。结论:aSAA高表达是hbv相关HCC患者肝切除术后MVI和早期肿瘤复发的独立危险因素。因此,aSAA蛋白水平可能是预测这些患者MVI和早期复发的有希望的生物标志物。
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.