e抗原阴性, 肝癌的危险分层

StephenW

Risk Stratification of Hepatocellular Carcinoma in Hepatitis B Virus e Antigen–Negative Carriers by Combining Viral Biomarkers

    Tai-Chung Tseng1,3,7,
    Chun-Jen Liu2,3,
    Chi-Ling Chen3,
    Hung-Chih Yang2,6,
    Tung-Hung Su2,3,
    Chia-Chi Wang1,7,
    Wan-Ting Yang4,
    Stephanie Fang-Tzu Kuo8,
    Chen-Hua Liu2,3,
    Pei-Jer Chen2,3,
    Ding-Shinn Chen2,3 and
    Jia-Horng Kao2,3,4,5

+ Author Affiliations

    1Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, New Taipei
    2Division of Gastroenterology, Department of Internal Medicine
    3Graduate Institute of Clinical Medicine
    4Hepatitis Research Center
    5Department of Medical Research
    6Department of Microbiology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei
    7School of Medicine, Tzu Chi University, Hualien, Taiwan
    8St. Vincent's Hospital, Melbourne, Australia

    Correspondence: Jia-Horng Kao, MD, PhD, Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te St, Taipei 10002, Taiwan ([email protected]).

Abstract

Background. The serum hepatitis B virus (HBV) surface antigen (HBsAg) level can predict hepatocellular carcinoma (HCC) development in hepatitis B e antigen (HBeAg)–negative patients with an HBV DNA level of <2000 IU/mL. However, little is known regarding how well the combination of both viral biomarkers stratifies HCC risk.

Methods. A total of 2165 Taiwanese HBeAg-negative noncirrhotic patients were followed for 14.9 years. The predictive power of the HBsAg level for HCC was analyzed for different viral load ranges.

Results. In patients with HBV DNA levels of 2000–19 999 IU/mL (intermediate viral load), a positive correlation between HBsAg level and HCC development was identified after adjustment for other risk factors (P=.002). In contrast, no association was found between HBsAg level and HCC in patients with higher viral loads. HBsAg level was subsequently included to stratify HCC risk in patients with low and intermediate viral loads. Receiver operating characteristic curve analysis showed that combining HBV DNA and HBsAg level better predicts 10-year HCC development as compared to using HBV DNA level alone in the overall cohort (P=.028).

Conclusions. Serum HBsAg level helps stratify HCC risk in patients with intermediate viral loads. Combining HBV DNA and HBsAg levels better predicts HCC risk.

StephenW

背景。血清乙型肝炎病毒（HBV）表面抗原（HBsAg）水平可以预测肝细胞癌（HCC）的发展，乙肝e抗原（HBeAg）阴性患者HBV DNA <2000 IU / mL的水平。然而，很少有人知道关于如何以及两个病毒标志物相结合的分层肝癌的风险。

方法。共2165台湾HBeAg阴性肝硬化的患者随访14.9年。肝癌的乙肝表面抗原水平的预测能力，分析不同的病毒载量范围。

的结果。在患者的HBV DNA水平2000-19 999 IU /毫升（中间病毒载量），乙肝表面抗原水平和肝癌发展的确定调整后的其他风险因素（P = 0.002）呈正相关关系。相反，没有协会之间发现乙肝表面抗原水平和肝癌患者病毒载量较高。 HBsAg的水平，其后包括，进行分层肝癌患者病毒载量低和中间风险。受试者工作特征曲线分析表明，结合HBV DNA和HBsAg水平，更好地预测10年肝癌的发展比单独使用HBV DNA水平在整体队列（P = .028）。

结论。中间病毒载量的患者血清HBsAg水平有助于肝癌的风险分层。结合HBV DNA和HBsAg水平，更好地预测肝癌风险。

tongkong

在十年前电信不发达的情况之下，能对2165肝硬化病人坚持14.9年进行随访是什么概念……

StephenW

tongkong 发表于 2013-6-6 22:33
在十年前电信不发达的情况之下，能对2165肝硬化病人坚持14.9年进行随访是什么概念…… ...

一个很好的医疗系统.

MP4

tongkong 发表于 2013-6-6 22:33
在十年前电信不发达的情况之下，能对2165肝硬化病人坚持14.9年进行随访是什么概念…… ...

10年前早就有固定电话了好不。