TE准确的风险HBV相关肝癌患者亚临床诊断肝硬化

StephenW

TE accurate in diagnosing subclinical cirrhosis in patients at risk for HBV-related HCC

Kim SU, et al. Hepatology. 2015;doi:10.1002/hep.27735.  
June 29, 2015

   
Researchers in Korea used transient elastography and found it to be useful in identifying subclinical cirrhosis among patients at risk for hepatitis B virus infection-related hepatocellular carcinoma who did not have evidence of cirrhosis, according to study data.

“We showed that [transient elastography] can identify patients with [subclinical cirrhosis] who are at increased risk of developing [hepatocellular carcinoma] in [chronic hepatitis B] patients without clinical evidence of [liver stiffness],” the researchers wrote. “The concept of [transient elastography]-defined [subclinical cirrhosis] might help the physician to modify the management and surveillance strategies for [chronic hepatitis B] patients and also activate following studies in this field.”

Researchers, including Seung Up Kim, MD, PhD, and Kwang-Hyub Han, MD, department of internal medicine, Yonsei University College of Medicine, Seoul, Korea, analyzed data of 2,876 patients without clinical cirrhosis who underwent transient elastography (TE) examinations between April 2006 and December 2012. Subclinical cirrhosis (SCC) was defined as a non-clinical cirrhosis with a liver stiffness (LS) of at least 13 kPa.

Sixty-two percent of patients enrolled in the study were male. Of all the patients, the mean LS value was 7.9 kPa, and SCC was found in 9.9% of patients (n = 285).

The median follow-up period was 48.9 months and during this time, researchers found that the cumulative incidence rate of HCC in the SCC group was significantly higher than that in the non-SCC group (P < .001). The cumulative incidence rate was 1.3% at 3 years, 2.3% at 5 years and 5.2% at 7 years. Overall, 52 patients developed HCC, of which 16 patients had SCC and 36 patients did not have SCC.

The mean LS value of patients with SCC was 22.7 kPa and these patients had higher proportions of diabetes, hypertension, total bilirubin and alpha-fetoprotein compared with the non-SCC group. Patients without SCC had higher serum albumin and platelet count compared with the SCC patients (P < .001 for both).

Multivariate analysis showed SCC to be independently associated with a risk of developing HCC, regardless of antiviral therapy (without antiviral therapy: HR = 4.68; 95% CI, 1.187-18.441; P = .027 vs. with antiviral therapy:

StephenW

TE准确的风险HBV相关肝癌患者亚临床诊断肝硬化

金苏，等。肝病。 2015年，DOI：10.1002 / hep.27735。
2015年6月29日

   
在韩国的研究人员使用瞬时弹性成像，发现它根据研究数据在鉴定的患者亚临床肝硬化的风险谁没有肝硬化的证据，乙肝病毒感染相关的肝癌有用的。

“我们发现，[瞬时弹性成像]可以识别患者[肝硬化亚临床]谁在开发中[慢性乙型肝炎]病人[肝癌]无[肝脏硬度]的临床证据的风险增加，”研究人员写道。 “[瞬时弹性成像] -defined [亚临床肝硬化]的概念可能帮助医生修改的管理和监控策略[慢性乙型肝炎]患者，也激活以下研究在这一领域。”

研究人员，包括升最多金，医学博士，和KWANG-Hyub汉族，医学博士，内科，医学，韩国首尔延世大学分析了2,876例患者数据，而无需临床肝硬化谁接受瞬时弹性成像（TE）考试2006年4月至十二月2012年亚临床性肝硬化（SCC）被定义为一个非临床肝硬化至少有13千帕的肝脏硬度（LS）。

患者参加了学习六十二％为男性。所有的患者，平均LS值是7.9千帕，和SCC被发现在患者（n = 285），9.9％。

中位随访期为48.9个月，在此期间，研究人员发现，肝癌的SCC组中的累积发病率比非SCC组（P <0.001）显著高。累计发病率为3年1.3％，5年2.3％和7岁5.2％。总体而言，52例患者发生HCC，其中16例有鳞癌和36例没有SCC。

患者SCC平均LS值是22.7千帕和这些患者有糖尿病，高血压，总胆红素和甲胎蛋白的较高比例与非SCC组比较。患者无SCC有较高的血清白蛋白，血小板与SCC患者（P <.001两者）计数相比。

多变量分析显示的SCC被独立地与显影肝癌的风险，无论抗病毒治疗相关的（无抗病毒治疗：HR = 4.68; 95％CI，1.187-18.441; P = 0.027与抗病毒治疗：HR = 3.344; 95％CI，1.526-7.328; P = 0.003）。

“在未来，更多的研究来证实TE纳入当前的监测策略肝癌是有益的和具有成本效益，”研究人员得出结论 - 通过梅琳达·史蒂文斯

披露：研究人员报告没有相关财务披露。