EASL2015:的非肝硬化肝癌的风险预测 癌与慢性乙型肝炎病毒患

StephenW

P0609
RISK PREDICTION OF NON-CIRRHOTIC HEPATOCELLULAR
CARCINOMA IN PATIENTS WITH CHRONIC HEPATITIS B VIRUS
INFECTION
W.-J. Jeng1,2,3, H.I Yang4, J. Liu4,5, M.-H. Lee3, C.-L. Jen4,5, R. Batrla-
Utermann6, S.-N. Lu7,8, L.-Y. Wang9, S.-L. You4, C.-J. Chen4,5, for the
R.E.V.E.A.L.-HBV Study Group. 1Department of Gastroenterology and
Hepatology, Division of Hepatology, Chang Gung Memorial Hospital,
Linkou, 2College of Medicine, Chang Gung University, 3Institute of
Clinical Medicine, National Yang Ming University, 4Genomics Research
Center, Academia Sinica, 5Graduate Institute of Epidemiology and
Preventive Medicine, College of Public Health, National Taiwan
University, Taipei, Taiwan; 6Roche Diagnostics Ltd., Switzerland,
Switzerland; 7Division of Hepato-Gastroenterology (Department
of Internal Medicine), Kaohsiung Chang Gung Memorial Hospital,
Kaohsiung, 8Chang Gung University, Kaohsiung, 9MacKay Medical
College, Taipei, Taiwan
E-mail: [email protected]
Background and Aims: One-third of chronic hepatitis B (CHB)
related hepatocellular carcinoma (HCC) patients are non-cirrhotic.
This study aimed to investigate the risk factors of HCC in those
non-cirrhotic CHB patients
Methods: This analysis included hepatitis B surface antigen
(HBsAg)-seropositive participants from the Risk Evaluation of
Viral Load Elevation and Associated Liver Disease/Cancer in
HBV (R.E.V.E.A.L.-HBV) cohort. Patients with evidence of cirrhosis
at entry were excluded. Cirrhosis and HCC were ascertained
through regular follow-up ultrasonography, linkage with national
health database, and medical chart reviews. Factors included age,
gender, HBV e antigen (HBeAg) status, serum levels of HBVDNA,
quantitative serum HBsAg levels, Co-infection with HCV, alanine
aminotransferase (ALT), habits of smoking, alcohol consumption,
family history of HCC, body-mass index, and diabetes mellitus
history were analyzed between LC related HCC and non-LC related
HCC patients. Multinomial logistic regression was applied for risk
factors investigation.
Results: There were 187 patients developed HCC in 3776 CHB
patients, 66 of them were non-cirrhotic HCC patients. Older age
(>50 vs. <50 year-old, OR: 4.42 [2.15–9.06], P = 0.000), family
history of HCC (OR: 3.03 [1.38–6.68], P = 0.006), cigarette smoking
habit (OR: 2.02 [1.05–3.86], P = 0.035), alcohol consumption habit
(OR: 2.17 [1.16–4.05], P = 0.015), elevated ALT (15–45 vs. <15 U/L,
OR: 2.263 [1.279–4.003], P = 0.005; >45 vs. <15 U/L, OR: 3.431
[1.520–7.744], P = 0.003), HBVDNA >106 copies/mL in HBeAgseronegative
patients (OR: 2.83 [1.081–7.406], P = 0.034 vs. HBeAgseronegatives
with HBVDNA <106 copies/mL), or HBeAg positivity
(OR: 3.679 [1.791–7.558], P = 0.000) are independent risk factors for non-cirrhotic HCC in CHB patients.
Conclusions: Smoking, alcohol drinking, family history of HCC,
abnormal LFT, HBVDNA >106 copies/mL and HBeAg seropositive
status are predictors of non-cirrhotic HCC in CHB patients

StephenW

P0609
的非肝硬化肝癌的风险预测
癌与慢性乙型肝炎病毒患者
感染
W.-J. Jeng1,2,3，H.I Yang4，J. Liu4,5，M.-H. Lee3，C.-L. Jen4,5，R. Batrla-
Utermann6，S.-N. Lu7,8，L.-Y. Wang9，S.-L. You4，C.-J. Chen4,5，对于
R.E.V.E.A.L.乙肝病毒研究小组。消化内科教研室的和
肝病，肝病，长庚医院的分部，
林口长庚大学2College医学，中，3Institute
临床医学，国立阳明大学，4Genomics研究
中心，中央研究院，流行病学研究所5Graduate和
预防医学，公共卫生学院，国立台湾
大学，台北，台湾; 6Roche诊断有限公司，瑞士，
瑞士;肝，消化7Division（系
内科），高雄长庚医院，
高雄，8Chang长庚大学，高雄医学9MacKay
大学，台北，台湾
电子信箱：[email protected]
背景和目的：三分之一的慢性乙型肝炎（CHB）
相关肝细胞癌（HCC）患者非肝硬化。
本研究旨在探讨肝癌在这些危险因素
非肝硬化CHB患者
方法：此分析包括乙肝表面抗原
（乙肝表面抗原）从风险评估-seropositive参与者
病毒载量高程及相关肝病/巨蟹座
HBV（R.E.V.E.A.L.-HBV）队列。肝硬化患者的证据
在条目被排除在外。肝硬化和肝癌被确定
通过定期随访超声检查，联​​动全国
健康数据库和病历审查。因素包括年龄，
性别，乙肝病毒e抗原（HBeAg）状态，HBVDNA的血清水平，
定量血清HBsAg水平，共感染了HCV，丙氨酸
转氨酶（ALT），吸烟习惯，饮酒量，
HCC的家族史，体重指数，和糖尿病
LC相关肝癌和非LC相关的历史进行了分析
肝癌患者。多项Logistic回归应用于风险
因素调查。
结果：分别有187例慢性乙型肝炎3776肝癌发展
患者，其中66人非肝硬化肝癌患者。年龄
（> 50与<50岁或：4.42 [2.15-9.06]，P = 0.000），家庭
肝癌史（OR：3.03 [1.38-6.68]，p = 0.006），吸烟
习惯（OR：2.02 [1.05-3.86]，P = 0.035），饮酒习惯
（OR：2.17 [1.16-4.05]，P = 0.015），ALT升高（15-45主场迎战<15 U / L，
OR：2.263 [1.279-4.003]，P = 0.005; > 45与<15 U / L，OR：3.431
[1.520-7.744]，P = 0.003），HBVDNA> 106拷贝/ ml在HBeAgseronegative
患者（OR：2.83 [1.081-7.406]，P = 0.034主场迎战HBeAgseronegatives
与HBVDNA <106拷贝/ mL），或e抗原阳性
（OR：3.679 [1.791-7.558]，P = 0.000）的独立危险因素，慢性乙型肝炎患者的非肝硬化肝癌。
结论：吸烟，饮酒，肝癌家族史，
异常LFT，HBVDNA> 106拷贝/ ml和HBeAg阳性
状态是慢性乙型肝炎患者的非肝硬化肝癌的预测