监视期间较短，在病毒性肝炎患者中检测到更小的HCC

StephenW

Shorter surveillance periods detected smaller HCC in patients with viral hepatitis
Wang J-H. Am J Gastroenterol. 2013;doi:10.1038/ajg.2012.445.

    January 24, 2013

Hepatocellular carcinoma ultrasonography surveillance conducted at 4-month intervals resulted in greater detection of smaller tumors among viral hepatitis patients than examination performed at 12-month intervals, according to study data.


In a community study in Taiwan, 744 adult patients with chronic viral hepatitis and thrombocytopenia were enrolled and randomly assigned to either 4-month (group A, n=387) or 12-month (group B, n=357) surveillance intervals to detect newly developed hepatocellular carcinoma (HCC). Surveillance was performed a mean of 7.13 and 2.53 times per patient in groups A and B, respectively, during the study that ran from April 2006 to September 2010.

Ultrasonography diagnosed HCC in 24 participants in group A and 15 in group B. Although 3-year cumulative incidence of HCC detection was similar between groups — 11.7% for group A, 9.7% for group B (P=.198) — smaller tumors were detected among 4-month surveillance patients (P=.006). HCC diameters in group A patients were a mean of 1.9 cm ± 0.7 cm vs. 2.9 cm ± 1.5 cm in group B, and more detected tumors were 2 cm or smaller in group A than in group B (P=.003). More patients in the 4-month surveillance interval group (37.5% vs. 6.7%) also had Barcelona Clinic Liver Cancer (BCLC) very-early stage (P=.017).

Using multivariate analysis, associated risk factors for HCC occurrence were male sex (HR=2.05; 95% CI, 1.05-4.01), liver cirrhosis (HR=23.3; 95% CI, 7.10-76.49) and platelet counts of less than 100 (x109)/L (HR=2.15; 95% CI, 1.13-4.08). Both groups showed no difference in overall survival at 4 years of follow-up, while patients who underwent recommended resection, radiofrequency ablation or transarterial embolization had better 4-year survival rates (P=.013).

“There was no difference in the detection rate of HCC between 4- and 12-month US surveillance intervals for patients with chronic viral hepatitis and thrombocytopenia,” the researchers concluded. “Compared with 12-month intervals, 4-month US surveillance intervals detected more patients with HCC 2 cm or less and in BCLC very-early stage for whom curative therapies might yield the best effects.”

StephenW

监视期间较短，在病毒性肝炎患者中检测到更小的HCC
王J-H。胃肠病学杂志。 2013年：10.1038/ajg.2012.445。

    2013年1月24日

在4个月的时间间隔进行肝癌超声监视在更大的更小的肿瘤检测病毒性肝炎患者比在12个月的时间间隔检查中，根据研究数据。

台湾在社会研究中，744名成人患者的慢性病毒性肝炎血小板减少症患者，随机分配为4个月（A组，n = 387）或12个月（B组，n = 357）监控间隔检测新开发的肝细胞癌（HCC）。进行监测，平均为7.13和2.53倍A组和B，每名患者分别在运行的研究，从2006年4月至2010年9。

超声诊断HCC组的24名学员和15日在B组，虽然3年累积发病率的肝癌检测是相似的 -  11.7％，A组，B组为9.7％（P = 0.198） - 更小的肿瘤检测到4个月的监测患者（P = 0.006）之间。 HCC直径A组患者的平均年龄分别为1.9厘米±0.7的厘米与2.9厘米±1.5厘米，B组和多个检测肿瘤2厘米或更小的A组较B组（P = 0.003）。更多的患者在4个月的监测间隔组（37.5％对6.7％），也有巴塞罗那临床肝癌（BCLC）非常早期的阶段（P = .017）。

使用多变量分析显示，肝癌的发生相关的危险因素是男性（HR = 2.05，95％CI，1.05-4.01），肝硬化（HR = 23.3，95％CI，7.10-76.49）和血小板计数小于100（ X109）/ L（HR = 2.15，95％CI，1.13-4.08）。这两个群体在总生存期无显着差异，在4年的随访，，谁接受建议切除术，射频消融术或血管栓塞的患者有更好的4年生存率（P = 0.013）。

“有没有区别肝癌的检出率在4  -  12个月的美国监测的时间间隔为慢性病毒性肝炎血小板减少症患者，研究人员得出结论。” “，12个月的时间间隔相比，美国4个月的监控间隔检测更多的患者与HCC 2厘米或以下，并在其中BCLC非常早期的阶段，治愈疗法可能会产生最好的效果。”