HBcrAg可以预测肝癌发展

StephenW

HBcrAg may predict HCC development
Published on April 27, 2016 at 5:15 PM · No Comments

  
By Shreeya Nanda

Research suggests a role for hepatitis B core-related antigen (HBcrAg) in the prediction of hepatocellular carcinoma (HCC) development in nucleos(t)ide analogue treatment-naïve patients with chronic hepatitis B virus (HBV) infection.

Researcher Toshifumi Tada (Ogaki Municipal Hospital, Japan) and team say that HBcrAg is "superior to HBV DNA [- a previously reported HCC risk predictor -] in terms of predictive power for HCC development."

But they stress the need for further prospective studies in community-based cohorts and patients who have received nucleos(t)ide analogue therapy.


During a median follow-up of 10.7 years, 78 of 1031 chronic HBV patients included in this medical review were diagnosed with HCC. The cumulative incidence rate of HCC was 2.0% at 5 years, rising to 8.3%, 10.7% and 12.5% at 10, 15 and 20 years, respectively.

Multivariate analysis taking into account various virus-related markers, such as HBV genotype and HBV DNA levels, showed that HBcrAg levels over 2.9 log U/mL predicted HCC development with a significant hazard ratio (HR) of 5.05 (p<0.001). The only other factor significantly associated with HCC progression was the presence of basal core promoter mutations (HR=28.85; p<0.001).

The cumulative incidence of HCC among patients with HBcrAg levels above 2.9 log U/mL and a basal core promoter mutation ranged from 6.4% at 5 years to 34.4% at 20 years, significantly higher than among their wild-type counterparts with HBcrAg levels at or below the cutoff, in whom it was 0.0% at all timepoints (p<0.001).

The accuracy of HBcrAg to predict HCC incidence, as estimated by time-dependant receiver operating characteristic analysis, was higher than for HBV DNA at all timepoints, at, for instance, 80% versus 75% at 2 years and 70% versus 65% at 10 years.

The authors conclude in the Journal of Hepatology that the "[e]levation of HBcrAg levels in [chronic HBV] patients is associated with the development of HCC", adding that in their view "HBcrAg is an excellent predictor" of progression to HCC.

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StephenW

HBcrAg可以预测肝癌发展
在5:15 PM·没有评论发表于2016年4月27日，

  
通过Shreeya南达

研究表明乙肝核心相关抗原（HBcrAg）在肝细胞癌（HCC）发展的预测核苷（酸）类似物IDE初治慢性乙型肝炎病毒（HBV）感染的作用。

研究员敏文田田（大垣市立医院，日本）和团队说HBcrAg是“优于HBV DNA [ - 先前报道的肝癌的风险预测 - ]在HCC发展的预测能力方面。”

但他们强调以社区为基础的同伙，谁收到核苷（酸）类似物IDE治疗的患者进一步的前瞻性研究的必要性。


在1070年的中位随访，包括在这个医疗审核被确诊肝癌1031 78的慢性HBV患者。肝癌的累积发病率为2.0％，5年，分别上升到8.3％，10.7％和12.5％在10年，15年和20年。

多因素分析考虑到各种病毒相关的标志物，如HBV基因型和HBV DNA水平，表明HBcrAg水平超过2.9日志U / mL的预测HCC开发5.05（P <0.001）的显著危险比（HR）。肝癌进展显著相关联的唯一因素是基础核心启动子突变的存在（HR = 28.85，P <0.001）。

肝癌的患者HBcrAg水平高于2.9日志U / mL和基底核心启动子突变之间的累积发生率从6.4％之间的5年至34.4％，在20岁，比它们的野生型对应与HBcrAg水平或间显著更高截止以下，在其中它是在所有时间点（p <0.001）0.0％。

HBcrAg的精度来预测肝癌发生率，由随时间变化的接收器操作特征分析估计，比为在所有时间点的HBV DNA较高，为，例如，80％与2年的75％和70％对65％，至10年。

作者在中华肝脏病杂志得出结论认为，“HBcrAg水平的[慢性HBV]患者[E] levation与肝癌的发生发展相关的”，并补充说在他们看来“HBcrAg是一个很好的预测”进展为肝癌。

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