是否抗血小板治疗切肝癌风险患者乙肝？

StephenW

November 17, 2015
Does Antiplatelet Therapy Cut Liver Cancer Risk in Patients with Hep B?

SAN FRANCISCO, CA—Aspirin and clopidogrel therapy are associated with reduced risk of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B infection, according to a study reported at the The Liver Meeting® 2015.

“Antiplatelet therapy was associated with a significantly lower incidence of hepatocellular carcinoma than [seen] in those not treated with antiplatelet therapy,” reported Minjong Lee, MD, of the Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, in Seoul, Korea, and colleagues. “Antiplatelet therapy might have significant effects on HCC prevention according to the severity of hepatic fibrosis.”

In mouse models, platelets promote the accumulation of virus-specific CD8 T cells in the liver, damaging liver tissue. “A recent study showed that the long-term use of the antiplatelet drugs in a mouse model of chronic hepatitis B can prevent hepatocarcinogenesis,” Dr. Lee said.

In order to determine the incidence of hepatocellular carcinoma in patients who were treated with anti-platelet drugs with incidence in those who were not, the researchers conducted a retrospective analysis “of data from 3,479 consecutive patients with chronic hepatitis B who had HBV DNA completely suppressed with antiviral treatment,” Dr. Lee explained. Group 1 was composed of 2,566 patients who had not been treated with anti-platelet drugs and Group 2 was composed of 592 patients treated with aspirin and/or clopidogrel.

According to multivariable analyses, Group 2 patients showed a significantly lower risk of HCC than that in Group 1 (HR 0.18; P<0.001), and all kinds of antiplatelets (aspirin monotherapy [HR 0.15, 95% CI: 0.06, 0.31; P<0.001]; clopidogrel monotherapy [HR 0.18, 95% CI: 0.04, 0.53, P=0.001], and aspirin/clopidogrel dual therapy [HR 0.23, 95% CI: 0.08, 0.51; P=0.009]) reduced the risk of HCC compared to Group 1.

In regards to bleeding events, patients in the aspirin group had a non-significant increased risk than the non-aspirin group (HR 1.49; P=0.163). Patients who took dual therapy with aspirin/clopidogrel (HR 2.46; P=0.041) had an increased risk compared to patients who took no antiplatelets (HR 4.69; P<0.001).

StephenW

二○一五年十一月十七日
是否抗血小板治疗切肝癌风险患者乙肝？

加利福尼亚州旧金山，阿司匹林和氯吡格雷治疗与肝细胞癌（HCC）的患者有慢性乙型肝炎病毒感染风险降低，据报道在肝脏Meeting®2015年的研究。

“抗血小板治疗与肝癌的显著发生率低于相关[见到]在那些不与抗血小板疗法治疗，”报道Minjong利，医学博士，内科及肝病研究所，医学首尔国立大学，首尔，韩国，和同事。 “抗血小板治疗可能根据肝纤维化的严重性有对肝癌预防显著效应”。

在小鼠模型中，血小板促进病毒特异性CD8 T细胞的积聚在肝，肝损伤组织。 “最近的一项研究表明，长期服用抗血小板药物治疗慢性乙型肝炎的小鼠模型可以预防肝癌，”李博士说。

为了确定谁在这些谁没有用抗血小板药物发生肝癌患者的发生率，研究人员连续3,479例慢性乙型肝炎谁了HBV DNA完全压制进行数据的回顾性分析“与抗病毒治疗，“李博士解释。第1组的组成为谁没有被用抗血小板药物和组2的组成为592患者阿司匹林和/或氯吡格雷治疗的患者2566。

根据多变量分析，2组患者表现肝癌的显著更低的风险比第1组（HR 0.18，P <0.001），以及各种抗血小板的（阿司匹林单药治疗[HR 0.15，95％CI：0.06，0.31，P <0.001];氯吡格雷单药治疗[HR 0.18，95％CI：0.04，0.53，P = 0.001]，而阿司匹林/氯吡格雷双重治疗[HR 0.23，95％CI：0.08，0.51，P = 0.009]）降低风险肝癌相比，第1组。

在问候出血事件，患者服用阿司匹林组有非显著增加的风险比非阿司匹林组（HR 1.49，P = 0.163）。患者谁了双重治疗与阿司匹林/氯吡格雷（HR 2.46，P = 0.041）的风险增加相比，谁没有采取任何抗血小板例（HR 4.69，P <0.001）。