Association of serum lactate dehydrogenase with prognosis and tumor metabolism in patients with hepatocellular carcinoma treated with atezolizumab plus bevacizumab therapy.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2024-08-04 DOI:10.1007/s00595-024-02914-x

Katsuya Toshida, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Takuma Izumi, Norifumi Iseda, Yuki Nakayama, Takuma Ishikawa, Tomoharu Yoshizumi

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Abstract

Purpose: Treatment outcomes are predicted by analyzing peripheral blood markers such as serum lactate dehydrogenase (LDH). We conducted this study to investigate whether serum LDH levels can predict the prognosis of patients treated with atezolizumab plus bevacizumab (ATZ/BEV) therapy for hepatocellular carcinoma (HCC) and whether LDH levels correlate with metabolic changes.

Methods: We enrolled 66 HCC patients treated with ATZ/BEV. Based on the change in serum LDH levels before and after treatment, the patients were divided into two groups, and the prognosis of each group was examined. Moreover, the association of LDH levels with tumor metabolism was analyzed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT).

Results: There were 32 patients categorized as the LDH-decrease group. Kaplan-Meier survival analysis indicated worse progression-free survival (PFS) in the LDH-increase group than in the LDH-decrease group (p = 0.0029). Multivariate analysis showed that an increase in the LDH level was an independent risk factor for worse PFS (p = 0.0045). The baseline LDH level correlated significantly with a high maximum standardized uptake value of ¹⁸F-FDG, according to the PET/CT findings. Transcriptomic analyses of specimens resected after ATZ/BEV therapy showed downregulated mitochondria-related pathways.

Conclusion: Serum LDH levels are a potential prognostic marker and an indicator of tumor metabolism.

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接受阿特珠单抗加贝伐单抗治疗的肝细胞癌患者血清乳酸脱氢酶与预后和肿瘤代谢的关系

目的：通过分析血清乳酸脱氢酶（LDH）等外周血标志物可预测治疗结果。我们开展了这项研究，探讨血清 LDH 水平能否预测接受阿特珠单抗加贝伐单抗（ATZ/BEV）治疗的肝细胞癌（HCC）患者的预后，以及 LDH 水平是否与代谢变化相关：我们纳入了66例接受ATZ/BEV治疗的HCC患者。根据治疗前后血清 LDH 水平的变化，将患者分为两组，并研究了每组患者的预后。此外，还通过氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）分析了LDH水平与肿瘤代谢的关系：结果：32例患者被归为LDH下降组。Kaplan-Meier生存分析显示，LDH增高组患者的无进展生存期（PFS）比LDH降低组更短（P = 0.0029）。多变量分析显示，LDH 水平升高是导致无进展生存期缩短的独立风险因素（p = 0.0045）。PET/CT结果显示，基线LDH水平与18F-FDG最大标准化摄取值显著相关。ATZ/BEV治疗后切除标本的转录组分析显示线粒体相关通路下调：结论：血清LDH水平是一种潜在的预后标志物，也是肿瘤代谢的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.