Abstract：
BACKGROUND: Currently, there is a scarcity of reliable biomarkers that can accurately forecast the outcome and prognosis of transarterial chemoembolization (TACE). In this study, we assessed the diagnostic efficacy of serum glutathione reductase (GR) as a biomarker for hepatocellular carcinoma (HCC) and its practicality in predicting TACE treatment response.
METHODS: The baseline positive rate and level of serum GR were analyzed and compared between HCC group and control group. Serum GR levels were assessed at three specific time points in 181 patients with unresectable HCC who underwent TACE (HCC-TACE). The correlation between serum GR levels and clinical pathological factors, tumor reactivity, and prognosis was investigated. The modified Response Evaluation Criteria in Solid Tumors (mRECIST) was utilized for assessing the treatment response to TACE. A nomogram for predicting the response to TACE treatment efficacy was developed.
RESULTS: Serum GR demonstrated superior diagnostic performance in HCC patients. The baseline levels of serum GR were associated with the patient\'s age, tumor size, BCLC staging, and tumor thrombi of the portal vein (TTPV) (p < 0.05). Elevated baseline levels of serum GR were also identified as independent prognostic factors for predicting lower overall survival (OS) and shorter time to radiological progression (TTP) (p < 0.001). Moreover, it is worth noting that non-responders group exhibited a substantial increase in median GR level in the fourth week following TACE treatment (p < 0.0001), whereas the median GR level of responders group did not display a significant augmentation (p > 0.05). Lastly, the changes in serum GRt1-t3 were negatively correlated with TTP (p < 0.001). The nomogram developed to predict the risk of mRECIST responsiveness in patients with HCC-TACE demonstrated excellent discriminatory ability.
CONCLUSIONS: Serum GR can serve as a valuable biomarker for the diagnosis of HCC and for predicting the therapeutic efficacy and prognosis of TACE treatment.
METHODS: The baseline positive rate and level of serum GR were analyzed and compared between HCC group and control group. Serum GR levels were assessed at three specific time points in 181 patients with unresectable HCC who underwent TACE (HCC-TACE). The correlation between serum GR levels and clinical pathological factors, tumor reactivity, and prognosis was investigated. The modified Response Evaluation Criteria in Solid Tumors (mRECIST) was utilized for assessing the treatment response to TACE. A nomogram for predicting the response to TACE treatment efficacy was developed.
RESULTS: Serum GR demonstrated superior diagnostic performance in HCC patients. The baseline levels of serum GR were associated with the patient\'s age, tumor size, BCLC staging, and tumor thrombi of the portal vein (TTPV) (p < 0.05). Elevated baseline levels of serum GR were also identified as independent prognostic factors for predicting lower overall survival (OS) and shorter time to radiological progression (TTP) (p < 0.001). Moreover, it is worth noting that non-responders group exhibited a substantial increase in median GR level in the fourth week following TACE treatment (p < 0.0001), whereas the median GR level of responders group did not display a significant augmentation (p > 0.05). Lastly, the changes in serum GRt1-t3 were negatively correlated with TTP (p < 0.001). The nomogram developed to predict the risk of mRECIST responsiveness in patients with HCC-TACE demonstrated excellent discriminatory ability.
CONCLUSIONS: Serum GR can serve as a valuable biomarker for the diagnosis of HCC and for predicting the therapeutic efficacy and prognosis of TACE treatment.
摘要：
背景：目前，缺乏能够准确预测经肝动脉化疗栓塞术(TACE)结局和预后的可靠生物标志物.在这项研究中,我们评估了血清谷胱甘肽还原酶(GR)作为肝细胞癌(HCC)生物标志物的诊断效能及其在预测TACE治疗反应方面的实用性.
方法：分析比较HCC组和对照组血清GR的基线阳性率和水平。在三个特定时间点评估181例接受TACE（HCC-TACE）的不可切除HCC患者的血清GR水平。血清GR水平与临床病理因素的相关性,肿瘤反应性，并对预后进行了调查。使用改良的实体瘤反应评估标准(mRECIST)来评估对TACE的治疗反应。开发了用于预测对TACE治疗功效的反应的列线图。
结果：血清GR在HCC患者中表现出优异的诊断性能。血清GR的基线水平与患者的年龄有关，肿瘤大小,BCLC分期，和门静脉癌栓（TTPV）（p<0.05）。血清GR的基线水平升高也被确定为预测较低的总生存期（OS）和较短的放射学进展时间（TTP）的独立预后因素（p<0.001）。此外，值得注意的是，在TACE治疗后的第4周，无反应者组的GR中位数水平显着增加（p<0.0001），而应答者组的中位GR水平没有显着增加(p>0.05)。最后,血清GRt1-t3的变化与TTP呈负相关(p<0.001)。用于预测HCC-TACE患者mRECIST反应性的风险的列线图显示出优异的辨别能力。
结论：血清GR可作为诊断HCC、预测TACE治疗效果和预后的有价值的生物标志物。
方法：分析比较HCC组和对照组血清GR的基线阳性率和水平。在三个特定时间点评估181例接受TACE（HCC-TACE）的不可切除HCC患者的血清GR水平。血清GR水平与临床病理因素的相关性,肿瘤反应性，并对预后进行了调查。使用改良的实体瘤反应评估标准(mRECIST)来评估对TACE的治疗反应。开发了用于预测对TACE治疗功效的反应的列线图。
结果：血清GR在HCC患者中表现出优异的诊断性能。血清GR的基线水平与患者的年龄有关，肿瘤大小,BCLC分期，和门静脉癌栓（TTPV）（p<0.05）。血清GR的基线水平升高也被确定为预测较低的总生存期（OS）和较短的放射学进展时间（TTP）的独立预后因素（p<0.001）。此外，值得注意的是，在TACE治疗后的第4周，无反应者组的GR中位数水平显着增加（p<0.0001），而应答者组的中位GR水平没有显着增加(p>0.05)。最后,血清GRt1-t3的变化与TTP呈负相关(p<0.001)。用于预测HCC-TACE患者mRECIST反应性的风险的列线图显示出优异的辨别能力。
结论：血清GR可作为诊断HCC、预测TACE治疗效果和预后的有价值的生物标志物。
