肝癌在慢性乙肝患者的瞬时弹性定义的隐性肝硬化的危险性

StephenW

Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with transient elastography–defined subclinical cirrhosis

    Mi Na Kim1,
    Seung Up Kim1,2,*,
    Beom Kyung Kim1,2,
    Jun Yong Park1,2,
    Do Young Kim1,2,
    Sang Hoon Ahn1,2,5,
    Ki Jun Song3,
    Young Nyun Park4 and
    Kwang-Hyub Han1,2,5,*

Article first published online: 20 MAR 2015

DOI: 10.1002/hep.27735

© 2015 by the American Association for the Study of Liver Diseases

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    1    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
    2    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
    3    Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
    4    Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
    5    Brain Korea 21 Project for Medical Science, Seoul, Korea

*Address reprint requests to: Seung Up Kim, M.D., Ph.D., Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. E-mail: [email protected]; fax: +82-2-362-6884 or Kwang-Hyub Han, M.D., Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. E-mail: [email protected]; fax: +82-2-362-6884.

    Potential conflict of interest: Nothing to report.

    This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI10C2020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Early detection of liver cirrhosis in its subclinical stage is of paramount importance to identify high-risk individuals of developing hepatocellular carcinoma (HCC). This study investigated whether transient elastography (TE) can identify patients with subclinical cirrhosis (SCC) who are at increased risk of developing HCC among chronic hepatitis B (CHB) patients without clinical evidence of cirrhosis. A total of 2,876 CHB patients without clinical cirrhosis who received TE examinations between April 2006 and December 2012 were enrolled in this prospective study. SCC was defined as a nonclinical cirrhosis, but with a liver stiffness (LS) value ≥13 kilopascals (kPa). Mean age of the study population was 46.1 years, and male gender was predominant (n = 1,775; 61.7%). Mean LS value was 7.9 kPa, and SCC was identified in 285 (9.9%) patients. During the median follow-up period of 48.9 months (range, 6.6-96.2), HCC developed in 16 patients (13.3 per 1,000 person-years) in the SCC group and 36 (3.4 per 1,000 person-years) in the non-SCC group. Cumulative incidence rate of HCC in the SCC group was significantly higher than that in the non-SCC group (P < 0.001, log-rank test). On multivariate analysis, SCC was independently associated with a risk of developing HCC, regardless of antiviral therapy (without antiviral therapy: hazard ratio [HR]: 4.680; 95% confidence interval [CI]: 1.187-18.441; P = 0.027; with antiviral therapy: HR, 3.344; 95% CI: 1.526-7.328; P = 0.003). Conclusion: Our data suggest that TE can identify CHB patients with SCC who are at increased risk of developing HCC, even when cirrhosis is not clinically apparent. (Hepatology 2015)

StephenW

肝癌在慢性乙肝患者的瞬时弹性定义的隐性肝硬化的危险性增加

    宓嗯啊Kim1，
    升向上Kim1,2，*，
    范庆Kim1,2，
    君永Park1,2，
    做年轻Kim1,2，
    桑勋Ahn1,2,5，
    奇骏Song3，
    年轻Nyun Park4和
    刘广Hyub Han1,2,5，*

文章首次在网上公布：2015年3月20日

DOI：10.1002 / hep.27735

©2015年肝病研究的美国协会

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    内科，医学延世大学，首尔，韩国1系
    消化内科2研究所，医学延世大学，汉城
    生物统计学系3，医学，韩国首尔延世大学
    病理4系，医学院，韩国首尔延世大学
    5脑韩国21项目的医学科学，汉城

*地址转载要求：升最多金，医学博士，内科，医学延世大学，250 Seongsanno，西大门区，首尔120-752，韩国。电子邮件：[email protected];传真：+ 82-2-362-6884或刘广Hyub汉族，医学博士，内科，医学延世大学，250 Seongsanno，西大门区，首尔120-752，韩国。电子邮件：[email protected];传真：+ 82-2-362-6884。

    潜在的利益冲突：没什么报告。

    这项研究是由赠款韩国医疗技术的R＆D项目，厚生省，大韩民国（HI10C2020）的支持。资助者曾在研究设计，数据收集和分析，发布决定，或准备的手稿没有作用。

在亚临床阶段，早期发现肝硬化是非常重要的，以确定开发肝细胞癌（HCC）的高危人群。本研究瞬时弹性（TE）是否能够识别患者的亚临床性肝硬化（SCC）谁在当中慢性乙型肝炎（CHB）的患者发展肝癌没有肝硬化的临床证据的风险增加。总共有2876例慢性乙型肝炎患者无临床肝硬化谁收到2006年4月和2012年12月间TE考试参加本前瞻性研究。 SCC被定义为一个非临床肝硬化，但与肝脏硬度（LS）的值≥13千帕（kPa）的。研究人群的平均年龄为46.1岁，男性是主要的（N = 1775; 61.7％）。平均LS值是7.9千帕，而SCC在285（9.9％）的患者识别。在中位随访期为48.9个月（6.6-96.2），HCC在非SCC开发的SCC组16例（13.3每1000人年）和36（3.4每1000人年）组。 HCC的SCC组的累积发病率较显著高于非SCC组（P <0.001，log-rank检验）。 ;：风险比[HR]：95％置信区间[CI] 4.680：多变量分析显示，SCC是独立与发展HCC，无论抗病毒治疗的风险（不抗病毒治疗相关1.187-18.441; P = 0.027;抗病毒治疗：HR，3.344; 95％CI：1.526-7.328; P = 0.003）。结论：我们的数据表明TE能够识别CHB患者与SCC谁在显影HCC的风险增加，即使当肝硬化是临床不明显。 （2015年肝病）

hao2014

什么意思??
相关还是不相关?

战天斗hbv

hao2014 发表于 2015-3-22 10:43
什么意思??
相关还是不相关?

我的理解、应该是相关的、求斧正