血清高密度脂蛋白胆固醇预测乙型肝炎病毒和丙型肝炎病毒阴性肝细胞癌患者发生门静脉癌栓及预后的价值研究

Background  Portal vein tumor thrombosisPVTT is a common complication of hepatocellular carcinomaHCC. The presence of PVTTHCC-PVTT at diagnosis often signifies advanced liver cancerworsened liver functionincreased risk of intrahepatic disseminationsystemic metastasisand complications related to portal hypertension. Currentlythe diagnosis of PVTT primarily depends on imaging techniqueswith a notable lack of simple and cost-effective diagnostic markers to complement and enhance the prediction of PVTT occurrence. Objective  To investigate the impact of serum high-density lipoprotein-cholesterolHDL-C levels on the development of PVTT in patients with non-Bnon-C hepatocellular carcinomaNBNC-HCCwe aimed to explore the predictive value of HDL-C levels for PVTT occurrence. Methods  A total of 119 patients diagnosed with NBNC-HCC admitted to the Third Hospital of Hebei Medical University from January 2015 to December 2020including 26 patients with PVTT were selectedand 102 patients with HBV and HCVassociated hepatocellular carcinomaBC-HCC hospitalized during the same periodincluding 34 patients with PVTT were selected. Baseline data were collected through the electronic inpatient record systemand patients with NBNC-HCC were followed up until December 312022 to record their overall survival. Patients with PVTT in NBNC-HCC and BC-HCC were categorized into the NBNC-PVTT groupn=26 and BC-PVTT groupn=34respectivelyand their baseline characteristics were compared. AdditionallyNBNC-HCC patients were divided into the PVTT groupn=26 and the non-PVTT groupn=93based on the presence or absence of PVTTand comparisons were made regarding clinical baseline characteristics and survival outcomes between the two groups. Multivariate Logistic regression analysis was performed to identify independent factors influencing PVTT in NBNC-HCC. The predictive performance of HDL-C levels for PVTT in NBNC-HCC was evaluated using receiver operating characteristicROCcurves. Kaplan-Meier survival curves were plotted to assess the prognosis of NBNCHCC patients with PVTT at different HDL-C levels. Furthermorerestricted cubic spline plots were utilized to analyze the nonlinear relationship between HDL-C levels and the risk of mortality in NBNC-HCC patients. Results  Compared to the BC PVTT groupthe NBNC-PVTT group exhibited higher levels of agetotal bilirubinTBILdirect bilirubinDBILtotal cholesterolTCand low-density lipoprotein cholesterolLDL-Cwhile the proportion of males and the HDL-C levels were lowerP0.675 mmol/Ln=52.Survival curve analysis indicated that patients in the high HDL-C group had better survival outcomes than those in the low HDL-C group2 =6.383P<0.000 1. After adjusting for age and sexa nonlinear association between HDL-C levels and the risk of death in NBNC-HCC patients was observedNonlinear P=0.003 2. Conclusion  Serum HDL-C level serves as a predictive marker for the risk of progression of PVTT in NBNC-HCC patientsit also has a significant impact on the prognosis of NBNC PVTT patientsoffering valuable insights for risk classification management and prognosis enhancement.