Hepatocellular carcinoma screening practices and impact on survival among hepati

StephenW

J Viral Hepat. 2012 Aug;19(8):594-600. doi: 10.1111/j.1365-2893.2011.01577.x. Epub  2012 Jan 28.
Hepatocellular carcinoma screening practices and impact on survival among hepatitis B-infected Asian Americans.Sarkar M, Stewart S, Yu A, Chen MS, Nguyen TT, Khalili M.
SourceDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA             Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA             Chinatown Public Health Center, San Francisco Department of Public Health, San Francisco, CA             Department of Internal Medicine, University of California Davis, Sacramento, CA, USA.

AbstractSummary.  Asians Americans have a high burden of hepatitis B virus (HBV) associated hepatocellular carcinoma (HCC). HCC screening practices in this population are unknown. We aimed to investigate predictors and patterns of HCC screening and its impact on survival in HBV-infected Asian Americans. Clinical data were obtained from a retrospective cohort of 1870 HBsAg-positive Asians in San Francisco's safety net clinics. In 824 patients at-risk for HCC, screening (≥1 imaging and/or AFP per year) decreased from 67% to 47% to 24% from the 1st to 2nd to 10th year after HBV diagnosis, respectively. AFP, imaging, and imaging plus AFP were used in 37%, 14%, and 49% during the first year after diagnosis, and imaging plus AFP increased to 64% by the 10th year. Among 1431 patients followed in 2007, age 40-64 years, female gender, cirrhosis, hepatologist evaluation, HBV diagnosis after 2003, and testing for HBeAg were associated with HCC screening. Of the 51 patients with HCC, more cirrhotics received screening and were diagnosed with early stage disease. Median survival following HCC diagnosis was higher in screened patients (1624 days vs. 111 days, P = 0.02). MELD score at HCC diagnosis (HR 1.2, 95% CI 1.1-1.3) and receipt of curative therapy (HR 0.3, 95% CI 0.08-0.94) were associated with survival. Screening rates in at-risk Asian Americans, particularly among noncirrhotics, were suboptimal and decreased over time. Among patients with HCC, receipt of prior screening improved survival, and this survival benefit was related to better liver function at HCC diagnosis and receipt of curative therapy.
© 2012 Blackwell Publishing Ltd.

StephenW

J病毒Hepat。 2012 08 19（8）:594-600。 DOI：10.1111/j.1365-2893.2011.01577.x。出处2012年01月28日。
肝癌筛查的做法和B型肝炎病毒感染的亚裔美国人之间的生存影响。
萨卡男，斯图尔特S，羽，陈MS，阮TT，哈利利M.
源

美国加州旧金山大学，旧金山，加利福尼亚，美国的家庭和社区医学部，旧金山，加州，旧金山，加州大学医学系，唐人街公共健康中心，旧金山，旧金山公共卫生部， CA内科，加州大学戴维斯大学，萨克拉门托，加利福尼亚，美国。
抽象

综述。亚裔美国人有B型肝炎病毒（HBV）的相关肝细胞癌（HCC）的高负担。在这一人群中肝癌筛查的做法是未知之数。我们旨在探讨肝癌筛选及其在HBV感染的亚裔美国人的生存影响的预测和模式。的临床资料进行回顾性队列在旧金山的安全网诊所从1870年HBsAg阳性亚洲人获得。在824例肝癌，筛选（≥1成像和/或每年法新社）从67％下降到47％至24％，从第一到第二乙肝诊断后10年，分别在风险。在确诊后的第一年，AFP，影像，和影像加法新社37％，14％和49％被用来成像加AFP由10年增加64％。其中1431例在2007年，年龄40-64岁，女性，肝硬化，肝病评价，2003年后乙肝诊断，测试和HBeAg的相关肝癌筛检。更肝硬化与肝癌的51例患者中，接受筛查和疾病早期诊断。以下肝癌诊断的中位生存期明显高于在筛选病人（1624天比111天，p = 0.02）。 MELD评分在肝癌诊断的得分（1.2人力资源，95％CI为1.1-1.3），与生存相关的根治性治疗后（0.3人力资源，95％CI 0.08-0.94）。筛检率在高危亚裔美国人，尤其是noncirrhotics，是最理想的，随着时间的推移而降低。在肝癌患者中，收到事先筛选改善生存，这种生存利益与肝癌诊断的肝功能和更好的根治性治疗后。

©2012 Blackwell出版有限公司

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