核苷（酸）类似物IDE和肿瘤复发的乙肝相关性肝癌射频消融

StephenW

Association between nucleos(t)ide analogue and tumor recurrence in HBV-related hepatocellular carcinoma after radiofrequency ablation

    Teng-Yu Lee1,2, Jaw-Town Lin3,4,5, Yi-Siou Zeng1, Yi-Ju Chen6,7, Ming-Shiang Wu8 andChun-Ying Wu1,6,9,10,*

DOI: 10.1002/hep.28266

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

Issue
Cover image for Vol. 62 Issue
Hepatology

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
Article has an altmetric score of 1

    1    Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan
    2    Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
    3    School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
    4    Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
    5    Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan
    6    Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
    7    Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
    8    Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    9    College of Public Health and Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
    10    Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan

*Correspondence: Chun-Ying Wu, MD, PhD, MPH, Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sect. 4, Taichung 40705, Taiwan, E-mail: [email protected]; Tel: +886-4-23592525 # 3304; Fax: +886-4-23741331

Keywords:

    local ablation;liver tumor;antiviral;nucleoside

Abstract

Radiofrequency ablation (RFA) is the best choice for curative treatment of hepatocellular carcinoma (HCC) cases not suitable for surgical intervention, but efforts should be made to reduce the risk of tumor recurrence. We aimed to investigate the association between nucleos(t)ide analogue (NA) therapy for hepatitis B virus (HBV) and the risk of HCC recurrence following RFA. Using the Taiwan National Health Insurance Research Database between July 1, 2004 and December 31, 2012, we screened 48,807 patients with newly diagnosed HBV-related HCC. We identified 850 patients (200 patients who used NAs for more than 90 days and 650 patients who never used NA after RFA) who received RFA as a potentially curative treatment for HCC. Patients in the NA-treated cohort were randomly matched 1:2 with patients in the untreated cohort by age, gender, cirrhosis, and the time period between RFA and initiation of NA therapy. Finally, 133 patients were recruited in the NA-treated group and 266 in the untreated group for analysis. Cumulative incidences of and hazard ratios (HRs) for HCC recurrence were analyzed after adjusting for competing mortality. The HCC recurrence rate of the NA-treated group was significantly lower than that of the untreated group (2-year recurrence rate: 41.8%, 95% confidence interval [CI]: 32.9-50.6% vs. 54.3%, 95% CI: 48.0-60.6%; modified log-rank test P< 0.05). In modified Cox regression analysis, NA therapy was independently associated with a decreased risk of HCC recurrence (HR 0.69, 95% CI: 0.50-0.95; P< 0.05). Multivariate stratified analyses verified the association of NA therapy and decreased HCC recurrence in almost all patient subgroups. Conclusion: NA therapy was associated with a decreased risk of HCC recurrence among patients with HBV-related HCC following RFA. This article is protected by copyright. All rights reserved.

StephenW

核苷（酸）类似物IDE和肿瘤复发的乙肝相关性肝癌射频消融治疗后的相关性

    腾宇Lee1,2，鄂镇Lin3,4,5，易思欧Zeng1，易居Chen6,7，明史昂Wu8 andChun英Wu1,6,9,10，*

DOI：10.1002 / hep.28266

©2015年肝病研究的美国协会

问题
封面图片卷。 62问题
肝病

接受第（接受，未编辑的文章在网上和可引用出版。最后编辑记录的排版本将出现在未来的。）
文章的altmetric比分1

    肠胃病学和肝脏，台中荣民总医院，台中，台湾1部
    医药，中山医学大学，台中，台湾的2部
    医学辅仁大学3校，新北市，台湾
    内科，义大医院/义守大学，台湾高雄的4部
    5中心卫生政策研究和发展，国家卫生研究院，苗栗，台
    6医学院，医学院，国立阳明大学，台北，台湾的学校
    皮肤科，台中荣民总医院，台中，台湾的7系
    内科，台大医院，台北，台湾的8部
    的临床医学中国医科大学公共卫生与研究生学院，台中，台湾9学院
    生命科学国立中兴大学10系，台湾台中

*通讯：春颖悟，医学博士，博士，公共卫生硕士，胃肠及肝脏，台中荣民总医院，1650台大道，宗司。 4，台中40705台，电子邮箱：[email protected];联系电话：+ 886-4-23592525＃3304;传真：+ 886-4-23741331

关键词：

    局部消融;肝肿瘤，抗病毒核苷

抽象的

射频消融（RFA）为治愈性治疗的肝细胞癌（HCC）的情况下不适合外科手术的最佳选择，但应作出努力，以减少肿瘤的复发的风险。我们的目的是调查乙型肝炎病毒（HBV）和HCC复发以下RFA风险核苷（酸）类似物IDE（NA）治疗之间的关联。利用2004年7月1日和2012年12月31日，与台湾全民健康保险研究资料库，我们筛选出48807例新诊断乙肝相关的肝癌。我们确定了850例（200例谁使用NAS进行超过90天，谁没用过NA RFA后650例）谁接受RFA作为一个潜在的根治性治疗肝癌。在NA处理的队列患者随机匹配1:2与患者在未处理队列按年龄，性别，肝硬化和RFA和NA治疗开始之间的时间段。最后，133例患者被招募模型组进行分析NA治疗组和266英寸累计发生率和危险比（HR）为HCC复发调整竞争死亡后进行了分析。 NA处理组的肝癌复发率明显高于未治疗组（2年复发率显著降低：41.8％，95％置信区间[CI]：32.9-50.6％和54.3％，95％CI： 48.0-60.6％;修改后的日志秩检验P <0.05）。在修改Cox回归分析，NA治疗是独立与肝癌复发的风险降低（HR 0.69，95％CI：0.50-0.95; P <0.05）。多因素分层分析证实NA治疗的协会和几乎所有的患者亚组降低肝癌复发。结论：NA治疗与肝癌复发的患者与乙肝相关的肝癌射频消融之后降低风险。这篇文章是受版权保护的。版权所有。