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本帖最后由 bigben446 于 2016-4-24 19:43 编辑
RESULTS:
The 238 case-patients (4 with HCC) and 435 control-patients (9 with HCC)
1982-2013 28年的追踪研究中，238名S清除患者中4人肝癌，435名S未清除患者中9人肝癌
J Clin Gastroenterol. 2011 Jan;45(1):64-8. doi: 10.1097/MCG.0b013e3181dd558c.
HBsAg seroclearance in chronic hepatitis B: implications for hepatocellular carcinoma.
Kim JH1, Lee YS, Lee HJ, Yoon E, Jung YK, Jong ES, Lee BJ, Seo YS, Yim HJ, Yeon JE, Park JJ, Kim JS, Bak YT, Byun KS.
Author information
Abstract
GOALS AND BACKGROUND:
The long-term clinical course, including the development of hepatocellular carcinoma (HCC) after hepatic B surface antigen (HBsAg) seroclearance is not established. We discovered that the incidence of HCC and the risk factors for HCC in chronic hepatitis B (CHB) patients after HBsAg seroclearance.
STUDY:
During 28 years, 96 CHB patients with HBsAg seroclearance were retrospectively reviewed. These patients continued to undergo HCC surveillance. The median follow-up time from initial visit was 166.5 months (range, 7 to 321 mo).
RESULTS:
The mean age at the initial visit and at the time of seroclearance was 39.2 ± 10.6 years and 46.4 ± 9.9 years, respectively. The mean age at the time of HBsAg seroclearance was significantly lower (P=0.03) in patients with spontaneous HBsAg seroclearance than patients with treatment-associated HBsAg seroclearance. During a median of 56 months (range, 7 to 238 mo) of follow-up after HBsAg seroclearance, 6 (6.5%) patients developed HCC. The mean age at the time of developing HCC was 55.8 ± 10.3 years. On univariate analysis, the evidence of liver cirrhosis from the time of HBsAg seroclearance and age more than 45 years at the time of HBsAg seroclearance were significant risk factors for HCC development. In multivariate analysis, the evidence of liver cirrhosis at HBsAg seroclearance was the only significant risk factor for HCC development.
CONCLUSIONS:
HCC can develop after HBsAg seroclearance in patients with known cirrhosis. Patients who achieved HBsAg seroclearance at older age (>45) may have undiagnosed cirrhosis and hence remain at risk for HCC. HCC surveillance should be carried out for both of those patient populations.
http://onlinelibrary.wiley.com/doi/10.1111/apt.13621/abstract
https://www.ncbi.nlm.nih.gov/pubmed/20535028 |
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楼主: zgct
发表于 2016-4-24 16:05
