Validation of insulin-like growth factor-1 as a prognostic parameter in patients with hepatocellular carcinoma in a European cohort

被引:7
作者
Huber, Yvonne [1 ,2 ]
Bierling, Franziska [2 ]
Labenz, Christian [2 ]
Koch, Sandra [1 ,2 ]
Schmidtmann, Irene [3 ]
Kloeckner, Roman [4 ]
Schotten, Sebastian [4 ]
Huber, Tobias [5 ]
Lang, Hauke [5 ]
Woerns, Marcus A. [1 ,2 ]
Galle, Peter R. [2 ]
Weinmann, Arndt [1 ,2 ]
Weinmann-Menke, Julia [1 ,2 ]
机构
[1] Johannes Gutenberg Univ Mainz, Univ Med Ctr, CRU, Mainz, Germany
[2] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Internal Med, Mainz, Germany
[3] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Inst Med Biostat Epidemiol & Informat, Mainz, Germany
[4] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Diagnost & Intervent Radiol, Mainz, Germany
[5] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Gen Visceral & Transplant Surg, Mainz, Germany
关键词
Hepatocellular carcinoma; HCC; Overall survival; Clinical database; IGF-1; SCORING SYSTEM; RISK-FACTORS; CIRRHOSIS; SURVIVAL; RESERVE; CANCER; TOOL;
D O I
10.1186/s12885-018-4677-y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: In hepatocellular carcinoma (HCC), the third leading cause of cancer-related mortality worldwide, the Child-Turcotte-Pugh score (CTP) is one of the most established tools to assess hepatic reserve and determine survival. Serum levels of insulin-like growth factor-1 (IGF-1) are decreased in patients with chronic liver disease or HCC. A modified score combining circulating IGF-1 with the CTP score (IGF-CTP) was recently proposed. Methods: IGF-CTP scoring was evaluated in 216 patients diagnosed with HCC between 2007 and 2017 to assess the predictive value of serum IGF-1 levels for patient risk stratification and overall survival (OS). Results: Liver cirrhosis was identified in 80.1% of the study cohort, and alcohol-induced liver disease was the most frequent underlying cause of HCC (44.4%). Serum IGF-1 levels were significantly lower in patients with HCC in cirrhosis compared with non-cirrhotic HCC (p < 0.01). A lower serum level of IGF-1 was associated with more advanced stages of liver cirrhosis (p < 0.05) and cancer stages (p < 0.001). Median OS in the cohort was 11.4 months (range 0.5-118. 2 months). OS was significantly higher (10.9 vs. 7.9 months; p < 0.05) in patients with a serum IGF-1 level above the median of 43.4 ng/mL Patient reassignment using IGF-CTP scoring reclassified 35.6% of patients. Through reassignment, stratification regarding OS was comparable to CTP. Conclusions: This study is the first to investigate IGF-1 and the IGF-CTP classification in a European cohort of HCC patients. Serum IGF-1 correlates with OS in patients with HCC. However, the IGF-CTP classification was not superior compared to CTP score regarding OS.
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页数:10
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