探討肝癌患者血漿硒濃度與抗氧化能力及氧化壓力之關係—先驅性研究

The association of plasma selenium, antioxidant enzyme activities and oxidative stress in patients with hepatocellular carcinoma: a pilot study

葉佩沂(Pei-Yi Yeh)

指導教授 ： 黃詩茜

中山醫學大學/健康管理學院/營養學系碩士班/碩士(2017年)

摘要

肝臟在代謝過程中會產生大量自由基，若體內抗氧化物不足會使體內抗氧化機制失衡，促使細胞分化不完全造成肝細胞凋亡，最終可能演變成肝癌。硒為體內抗氧化酵素榖胱甘肽過氧化酶的重要組成之一，研究認為硒可保護細胞抵抗氧化壓力、自由基等攻擊，進而使得腫瘤細胞凋亡。但過去探討硒與癌症之相關研究結果並不一致，且針對肝癌患者其癌化程度、血漿硒濃度、氧化壓力與抗氧化能力之臨床研究也不多。因此本研究目的為評估不同期別肝癌患者血漿硒濃度；並探討肝癌患者血漿硒濃度與抗氧化能力及氧化壓力之相關。本研究於臺中榮民總醫院一般外科招募罹患肝癌患者，並依照巴塞隆納臨床肝癌分類，將受試者分為 stage 0 & A組 (n=22) 及 stage B組 (n=21)。結果顯示兩組受試者血漿硒濃度分別為129.2 與125.4μg/L，並無顯著差異。兩組受試者血液生化值、氧化壓力及抗氧化能力亦無顯著差異。進一步調整年齡、性別、身體質量指數、丙胺酸轉胺酶、抽菸及飲酒習慣與高敏感度C蛋白後，未發現血漿硒濃度與氧化壓力或抗氧化能力之相關性，這可能是因本研究受試者皆屬於較早期肝癌，其血漿硒濃度尚為足夠，而不影響氧化-抗氧化機制。

關鍵字

血漿硒濃度 ； 肝癌 ； 巴塞隆納臨床肝癌分類 ； 抗氧化能力 ； 氧 化壓力

並列摘要

There are various free radicals (FR) during the metabolism process in the liver. Fortunately, there are several methods to scavenge FR and maintain the oxidative/antioxidative balance in the liver. When the balance is disrupted, which is as known as oxidative stress, causing the impairment of hepatocyte differentiation and apoptosis, which are involved in the pathogenesis of hepatocellular carcinoma (HCC). Selenium is an important constituent of the enzyme glutathione peroxidase (GPx) and protects cell through defence against reactive oxygens, inhibits cancer cell growth. The results of retrospective study were inconsistent between plasma selenium concentration and HCC and lacks of studies that investigate the association of plasma selenium, antioxidant capacities and oxidative stress in patients with the different stage of HCC.
Therefore, the purposes of the study are evaluating the level of plasma selenium in patients with HCC in different stages and investigate the association of plasma selenium levels, antioxidant enzyme and oxidative stress in patients with HCC. We recruited patients with HCC in Taichung Veterans General Hospital. According to the Barcelona-clinic liver cancer (BCLC) stage, the subjects were separated into two groups, BCLC stage 0&A (n=22) and BCLC stage B (n=21). The results showed that plasma selenium concentration had no significant difference within groups (129.2 μg/L vs. 125.4μg/L). The oxidative stress indicators and antioxidant capacities were not significant difference within groups. However, plasma selenium levels had no significant associations among oxidative stress indicators and antioxidant capacities after adjusting age, sex, BMI, GPT, drinking, smoking and high sensitivity C- reactive protein. We didn't find the trends of oxidative stress antioxidative system might be due to these patients were belonging earlier stage of HCC, and the adequate levels of selenium in an antioxidative system.

並列關鍵字

plasma selenium levels ； hepatocellular carcinoma ； Barcelona-clinic liver cancer stage ； antioxidant enzyme activities ； oxidative stress

參考文獻

行政院衛生福利部。2010。國人膳食營養素參考攝取量，第七版。台灣。

Chen J. An original discovery: selenium deficiency and Keshan disease (an endemic heart disease). Asia Pac J Clin Nutr. 2012;21(3):320-6.

Arnao MB, Cano A, Hernández-Ruiz J, García-Cánovas F, Acosta M. Inhibition by L-ascorbic acid and other antioxidants of the 2.2'-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) oxidation catalyzed by peroxidase: a new approach for determining total antioxidant status of foods. Anal Biochem. 1996; 236:255-261.

Bettinger D, Schultheiss M, Hennecke N, Panther E, Knüppel E, Blum HE, Thimme R, Spangenberg HC. Selenium levels in patients with hepatitis C virus-related chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma: a pilot study. Hepatology. 2013; 57:2543-2544.

Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J. 2012; 5:9-19.