评论:家族史是重要的评估肝癌风险的慢性HBV感染者

StephenW

comment
January 13, 2014
Family History Is Important in Assessing HCC Risk in Chronic HBV Infection
Atif Zaman, MD, MPH reviewing Loomba R et al. Clin Gastroenterol Hepatol 2013 Dec.

The risk is especially elevated with seropositivity for hepatitis B surface antigen and is further multiplied by hepatitis B e antigen positivity or a high viral DNA load.

Family history of hepatocellular carcinoma (HCC) has been reported as a risk factor for HCC in patients with hepatitis B virus (HBV) infection. However, the magnitude of the risk has not been well characterized.

The current study is a sub-study of a prospective, community-based cohort study (the REVEAL study) that examined the risk factors for HCC in 22,472 participants with and without viral hepatitis in 7 townships in Taiwan. Patients underwent routine visits and were followed for a mean of 16 years. HCC was identified through the national cancer registry.

During 362,268 person-years of follow-up, 374 cases of HCC were identified. Among hepatitis B surface antigen (HBsAg)–negative patients, the cumulative risk for HCC was similar between patients with and without a family history of HCC (0.65% and 0.62%, respectively). The cumulative risks were higher in patients with chronic HBV infection (HBsAg-positive), both with a family history of HCC (15.8%) and without (7.5%). In multivariate analysis, the adjusted hazard ratio for HCC in HBsAg-positive patients with a family history of HCC compared with HBsAg-negative patients without a family history was 32.3 (95% confidence interval, 20.8–50.3). Among HBsAg-positive patients, a family history of HCC, high viral level (≥10,000 copies/mL), and HBeAg-positivity showed a statistically significant and synergistic association with HCC risk.
Comment

In this sub-study of a large, well-characterized cohort study, family history of hepatocellular carcinoma multiplied the risk for HCC throughout the course of hepatitis B virus infection. This suggests the influence of a shared host gene effect in the development of HCC. Consequently, in clinical practice, patients with HBV infection and a family history of HCC deserve special attention and should be routinely monitored and treated as soon as treatment criteria are met.
Editor Disclosures at Time of Publication
Citation(s):

    Loomba R et al. Synergistic effects of family history of hepatocellular carcinoma and hepatitis B virus infection on risk for incident hepatocellular carcinoma. Clin Gastroenterol Hepatol 2013 Dec; 11:1636. (http://dx.doi.org/10.1016/j.cgh.2013.04.043)

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StephenW

2014年1月13日
家族史是重要的评估肝癌风险的慢性HBV感染者
与Atif扎曼，医学博士，公共卫生审查Loomba R等。临床胃肠病学肝脏病杂志2013十二月

的风险尤其是血清阳性为乙肝表面抗原升高，并进一步乘以乙肝e抗原阳性或高病毒DNA载。

肝细胞癌（HCC ）的家族史已被报告为患者的乙型肝炎病毒（ HBV）感染的危险因素为肝癌。然而，风险的大小并没有得到很好的特点。

目前的研究是一项前瞻性，以社区为基础的队列研究（中披露研究） ，在22,472参与者与不病毒性肝炎的7个乡镇在台湾考察的危险因素肝癌的一个子研究。患者接受例行检查和随访，平均16年。肝癌是通过国家癌症登记确认。

在362268人 - 年的随访， 374例HCC进行了鉴定。其中乙肝表面抗原（HBsAg ）阴性的患者，肝癌的累积风险是患者和无肝癌（分别为0.65 ％和0.62 ％ ），家族史相似。累积的风险均高于慢性HBV感染（ HBsAg阳性） ，两者与肝癌家族史（ 15.8 ％ ）和无（ 7.5 ％ ） 。在多变量分析中，对于肝癌的HBsAg阳性患者肝癌家族史的校正风险比与HBsAg阴性患者无家族史相比为32.3 （ 95 ％可信区间为20.8-50.3 ） 。其中HBsAg阳性的患者，肝癌家族史，高病毒水平（ ≥ 10,000拷贝/毫升） ，和HBeAg -阳性表现与肝癌的风险在统计学上显著和协同关系。
评论

在一个大的，良好表征队列研究的这个子研究，肝癌家族史乘以肝癌的风险贯穿于乙肝病毒感染过程。这表明在肝癌的发展中共享宿主基因效应的影响。因此，在临床实践中，患者的HBV感染与肝癌家族史值得特别注意，应定期监测，并尽快处理标准得到满足处理。
在出版时编辑披露
引用（S ） ：

    Loomba R等。肝癌和乙型肝炎病毒感染的风险事件肝细胞癌家族史协同效应。临床胃肠病学肝脏病杂志2013月; 11:1636 。 （ http://dx.doi.org/10.1016/j.cgh.2013.04.043 ）

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jinpaimanman

这种翻译看得很不明白啊

StephenW

回复 jinpaimanman 的帖子

非常正确，因为是机械（谷歌）的翻译.