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本帖最后由 风雨不动 于 2012-4-14 14:55 编辑
Neth J Med. 2011 Nov-Dec;69(11):508-13.
Source: http://www.ncbi.nlm.nih.gov/pubmed/22279629
Quantitative HBV DNA and AST are strong predictors for survival after HCC
detection in chronic HBV patients. Witjes CD, IJzermans JN, van der Eijk
AA, Hansen BE, Verhoef C, de Man RA. SourceDepartment of Hepatobiliary and
Transplantation Surgery, Erasmus MC, University Medical Centre Rotterdam,
the Netherlands.
Abstract
Hepatitis B virus infection (HBV) is an important co-factor in the
development of hepatocellular carcinoma (HCC). We studied whether
quantitative HBV DNA at time of HCC detection influences survival of HCC
patients. All diagnosed HCC cases between 2000 and 2008 at our
university-based reference centre were analysed to determine the influence
of hepatitis B viral load on overall survival. Clinical and virological
findings were evaluated in univariate and multivariate analyses, survival
rates were assessed for HCC patients with a high viral load (HBV DNA ?10(5)
copies/ml) and low viral load (HBV DNA <10(5) copies/ml). HCC was
diagnosed in 597 patients, including 98 patients with HBV. The group of 37
patients (38%) who had a high viral load contained more HBeAg-positive
patients, had lower serum albumin levels and higher serum aspartate
aminotransferase (AST ) and alanine aminotransferase (ALT ) levels. The
one- and five-year survival rates of HCC patients with a high viral load
were 58% and 11% and for HCC patients with a low viral load 70% and 35%,
respectively. In multivariate analysis a higher AST level and higher viral
load were significantly associated with shorter overall survival (HR=2.30;
p=0.018, HR=1.22; p=0.015, respectively). HBeAg positivity, low albumin
level or high AST or ALT levels in HCC patients are associated with a
higher HBV DNA . HBV DNA level at detection is associated with overall
survival of HCC patients. These findings support the concept that after HCC
detection adequate suppression of HBV DNA by nucleoside analogue therapy
may improve survival.
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