Soluble Urokinase Plasminogen Activator Receptor Predicts Survival and Hepatic Decompensation in Advanced Hepatocellular Carcinoma

作者：Fabian Artusa, Sven Lamatsch, Minh Dinh Phan, Burcin Özdirik, Hilmar Berger, Mara Egerer, Jana Knorr‐Klocke, Janett Fischer, Rhea Veelken, Florian van Bömmel, Thomas Berg, Kai Kappert, R Tauber, Tobias Puengel, Cornelius Engelmann, Münevver Demir, Frank Tacke, Raphael U. Mohr · 发表于：Liver International · 年份：2025 · DOI：10.1111/liv.70121 · 被引用次数：8 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Protease and Inhibitor Mechanisms、Liver physiology and pathology

BACKGROUND AND AIMS: The introduction of immune checkpoint inhibitor (ICI) based therapies has significantly improved the prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the variable treatment response and the uncertain benefit in patients with advanced liver cirrhosis emphasise the urgent need for prognostic and predictive biomarkers guiding patient selection. The soluble urokinase plasminogen activator receptor (suPAR) is strongly associated with inflammation, liver cirrhosis and various types of cancer. In this study, we investigated suPAR as a potential novel biomarker in patients with unresectable HCC. METHODS: This multicenter retrospective study, conducted at three German tertiary care centers, included 90 patients with unresectable HCC and suPAR measurements prior to and during atezolizumab/bevacizumab therapy. Patients with liver cirrhosis without HCC (n = 235) and non-cirrhotic patients with other gastrointestinal tumours (n = 155) were selected as control cohorts. RESULTS: Median suPAR levels were significantly higher in patients with liver cirrhosis compared to non-cirrhotic cancer patients. A strong association with parameters of liver function, but not with HCC characteristics, was observed. In patients with HCC receiving atezolizumab/bevacizumab, suPAR was the most accurate independent predictor of hepatic decompensation and overall survival (OS). In addition, suPAR was able to stratify the risk of hepatic decompensation within ...