Abstract
BackgroundHepatocellular carcinoma has high incidence and mortality worldwide. Liver is the site of most metabolic biotransformation, which could reflect the status of cells. Most plasma apolipoproteins, endogenous lipids and lipoproteins are synthesized in the liver. Therefore, the effects of lipid metabolites on prognosis of HCC deserved to be explored.MethodsWe prospectively included 58 healthy donors (HD), 50 chronic hepatitis (CH) patients and a training cohort of 189 patients with HCC who underwent curative resections at Zhongshan Hospital from January 2012 to August 2012. We identified the optimal HDLPO cutoff value at 0.98 mmol/L and used it to stratify patients into low- or high-HDLPO groups for the entire cohort and four low-recurrent-risk subgroups. We also included an independent validation group of 182 HCC patients to validate this cutoff value. Prognostic values of HDLPO and other factors were determined by Kaplan–Meier curves and the Cox proportional hazards model.ResultsThe low-HDLPO group had a higher median tumor grade (P = 0.020) and a higher recurrence rate (P = 0.032). Results of multivariate analysis showed that preoperative γ-glutamyl transpeptidase (GGT) and HDLPO were independent predictors of recurrence. Moreover, the predictive value of HDLPO was retained in four low-recurrent-risk subgroups. As expected, clinicopathologic characteristics and predictive values were similar in the validation and training cohorts.ConclusionsHDLPO is an accessible predictor of HCC recurrence after liver resections that can help identify patients who need more careful monitoring and follow-up care.
Highlights
Hepatocellular carcinoma has high incidence and mortality worldwide
preoperative high-density lipoprotein (HDLPO) is an accessible predictor of Hepatocellular carcinoma (HCC) recurrence after liver resections that can help identify patients who need more careful monitoring and follow-up care
Lipid metabolism screening and optimal HDLPO cutoff We examined four products of lipid metabolism, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in 189 HCC patients before surgery, 58 healthy donors (HD) and 50 chronic hepatitis(CH) patients
Summary
Hepatocellular carcinoma has high incidence and mortality worldwide. Liver is the site of most metabolic biotransformation, which could reflect the status of cells. The effects of lipid metabolites on prognosis of HCC deserved to be explored. Advances in treatment have improved survival of patients with HCC, they suffer high post-surgical recurrence and metastasis rates [1, 3]. Metabolites are the best molecular indicators of cell status, and liver is the site of most metabolic biotransformation [5]. High-density lipoprotein (HDL), as a lipid metabolite, is known as “good cholesterol,” with the main function of reverse cholesterol transport (RCT) and negative correlation with atherosclerosis [8], little is known about alterations of metabolism, especially HDL, and how these multi-level variations affect aggressive diseases and poor outcomes. We designed this single-center prospective study of 189 patients in the training group and 182 patients in the validation group, as well as 58 HD and 50 CH patients, to explore whether HDL levels could predict HCC recurrence
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