干扰素-α治疗慢性B型肝炎患者肝癌的发生的影响

StephenW

干扰素-α治疗慢性B型肝炎患者肝癌的发生的影响
Dig Dis. 2012;30(6):568-73. doi: 10.1159/000343068. Epub  2012 Dec 13.
Effect of Response to Interferon-α Therapy on the Occurrence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B.Lee D, Chung YH, Lee SH, Kim SE, Lee YS, Kim KM, Lim YS, Lee HC, Lee YS, Yu E.
SourceDepartment of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

AbstractObjectives: The aim of this study was to examine whether interferon-α (IFN-α) therapy may reduce the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) and to determine its effect based on responsiveness to IFN-α therapy.

Methods: A total of 641 biopsy-proven CHB patients were treated with IFN-α2b. They were followed by biochemistry and/or imaging studies at 3- to 6-month intervals for a median period of 113 months (range 6-222). Results: HCC was detected in 22 patients and 5- and 10-year cumulative occurrence rates were 0.4 and 3.2%, respectively. In univariate analysis, age (p < 0.001), serum AFP levels (p < 0.001), and serum HBV-DNA levels (p = 0.002) at baseline were associated with HCC development. HCC occurred less frequently in biochemical responders at the end of treatment than in non-responders (p = 0.001). However, virologic response was not associated with HCC development. Multivariate analysis showed that poor biochemical response (p = 0.007) as well as older age (p = 0.018) and a higher serum AFP level (p < 0.001) remained independent predisposing factors of HCC development in CHB patients treated with IFN-α.
Conclusion: The results suggest that the biochemical but not virologic response to IFN-α therapy reduces independently the occurrence of HCC in patients with CHB.

StephenW

干扰素-α治疗慢性B型肝炎患者肝癌的发生的影响
李D，仲YH，李SH，SE金，李YS，金KM，林YS，李HC，李YS，于E.
源




目的：本研究的目的是检查是否干扰素-α（IFN-α）治疗可减少肝细胞肝癌（HCC）的发生在慢性乙型肝炎（CHB），并确定其影响的基础上IFN-α治疗的反应。方法：活检证实的641例慢性乙型肝炎患者的治疗与IFN-α2b的。其次是生物化学和/或影像学检查在3  - 6个月的间隔期为113个月的中位数（范围6-222）。结果：HCC中检测到22例5 - 10年累计发生率分别为0.4％和3.2％。单因素分析显示，年龄（P <0.001），血清AFP水平（P <0.001），并在基线血清HBV-DNA水平（P = 0.002），与HCC的发展。 HCC发生率较低，在治疗结束后的生化反应者比无反应者（P = 0.001）。然而，病毒学应答是不相关的HCC发展。多因素分析结果表明，可怜的生化反应（P = 0.007）和年龄（P = 0.018）和血清AFP水平（P <0.001），保持独立的诱发因素与IFN-α治疗慢性乙型肝炎患者的HCC发展。结论：结果表明，IFN-α治疗的生化，但不病毒学反应降低独立CHB患者发生HCC。

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