EASL 2013:肝硬化患者恩替卡韦应答发生肝癌的概率很低

StephenW

Abstract 652

VIROLOGICAL RESPONSE TO ENTECAVIR IS ASSOCIATED WITH LOW PROBABILITY OF DEVELOPING HEPATOCELLULAR CARCINOMA IN CHRONIC HEPATITIS B PATIENTS WITH CIRRHOSIS   
     
S.S. Kim*, S.J. Ahn, S.Y. Park, G.W. Song, J.Y. Cheong, S.W. Cho
Ajou University School of Medicine, Suwon, Republic of Korea. *[email protected]

Background and aims: The aim of this study was to assess the risk for the development of hepatocellular carcinoma (HCC) according to the underlying liver status and virological response (VR) to entecavir (ETV) in chronic hepatitis B patients with cirrhosis.
Patients and methods: A total of 324 patients with cirrhosis were treated with ETV for ≥ 6 months and were followed up (mean duration 36.0 months) for the occurrence of HCC. Patients who developed HCC within 6 months were excluded. VR was defined as HBV DNA undetectability (HBV DNA < 2000 copies/mL until June, 2008 and < 20 IU/mL after July, 2008).
Results: Two hundred and twenty (67.9%) patients had compensated cirrhosis and remaining (32.1%) patients had decompensated cirrhosis. The 5-year prevalence of HCC was 28.5%. Univariate analysis showed that increasing age (p = 0.002), male gender (p = 0.008), diabetes mellitus (p = 0.012), hepatic encephalopathy (p = 0.017) were significant risks for development of HCC. Low platelet and low serum albumin showed a trend to be risks for developing HCC (p = 0.089 and p = 0.090, respectively). VR was associated with lower HCC risk (p = 0.000). Cox regression analysis showed that age over 50 (p = 0.000, RR 2.906) and male gender (p = 0.005, RR 2.887) were independent risks for the development of HCC. Patients with VR had low probability for development of HCC (p = 0.000, RR 0.056).
Conclusions: Antiviral treatment with ETV does not completely eradicate the risk of developing HCC in patients with cirrhosis. However, VR to ETV is associated with a lower probability of developing HCC. Older age and male gender were significant independent risk factors for developing HCC in ETV-treated chronic hepatitis B patients with cirrhosis.


Assigned speakers:
Dr. Soon Sun Kim, Ajou University School of Medicine , Suwon , Republic of Korea

Assigned in sessions:
26.04.2013, 09:00-18:00, Poster Session, P02-03b, Category 03b: Liver tumors: Clinical (epidemiology, diagnosis), Poster Area

StephenW

背景和目的：本研究的目的是发展为肝细胞癌（HCC）的风险进行评估，根据潜在的肝脏状态和病毒学应答（VR），恩替卡韦（ETV）的慢性乙型肝炎，肝硬化患者。
患者和方法：共324例肝硬化患者，恩替卡韦治疗≥6个月随访（平均病程36.0个月）为肝癌的发生。 6个月内发展为HCC的患者被排除在外。 VR被定义为HBV DNA不可检测（HBV DNA <2000拷贝/毫升，直到6月，2008年和<20 IU /毫升，2008年7月后）。
结果：了两百二十（67.9％）患者肝硬化失代偿期肝硬化，其余（32.1％）患者有补偿。 5年的肝癌患病率是28.5％。单因素分析显示，年龄的增加（P = 0.002），男性（P = 0.008），糖尿病（P = 0.012），肝性脑病（P = 0.017），肝癌发展的重大风险。血小板低，低血清白蛋白呈趋势的风险发展为HCC（P = 0.089和P = 0.090）。 VR是与肝癌的风险较低（P = 0.000）。 Cox回归分析显示，年龄超过50岁（P = 0.000，RR = 2.906）和男性（P = 0.005，RR = 2.887）是独立的风险发展为肝细胞癌。患者肝癌（P = 0.000，RR = 0.056）的发展与VR的概率很低。
结论：恩替卡韦抗病毒治疗不彻底根除肝硬化患者发展为HCC的风险。然而，VR是与ETV发展肝癌的机率较低。 ETV治疗慢性乙型肝炎肝硬化患者发展为HCC的年龄较大，男性显着的独立危险因素。