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乙型和丙型肝炎病毒感染的临床特征,具有高甲胎蛋白水平

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才高八斗

发表于 2017-1-13 18:49 |显示全部帖子
Medicine (Baltimore). 2017 Jan;96(2):e5844. doi: 10.1097/MD.0000000000005844.
Clinical features of hepatitis B and C virus infections, with high α-fetoprotein levels but not hepatocellular carcinoma.Kim CY1, Kim BR, Lee SS, Jeon DH, Lee CM, Kim WS, Cho HC, Kim JJ, Lee JM, Kim HJ, Ha CY, Kim HJ, Kim TH, Jung WT, Lee OJ.
Author information
  • 1aDepartment of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju bDepartment of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon cInstitute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.


AbstractThe appropriate α-fetoprotein (AFP) level to confirm hepatocellular carcinoma (HCC) could be 100 ng/mL; however, the clinical significance of falsely elevated AFP in patients without HCC has not been fully studied. We investigated the clinical features and outcome of patients without HCC but with high AFP levels (100 ng/mL), especially with chronic hepatitis B (CHB) or C (CHC).The sample included 124 consecutive patients with CHB (n = 97) or CHC (n = 27), with AFP levels >100 ng/mL and without HCC at baseline. Multivariate Cox proportional regression analysis was performed to determine the factors associated with AFP normalization and HCC development.During the mean 52-month follow-up, the proportion of patients with CHB with AFP normalization (90.7%) was significantly higher than the proportion of patients with CHC (59.3%, P < 0.001). Initial aspartate aminotransferase levels (hazard ratio [HR] = 1.02 per 10 U/L increase, P = 0.021) and antiviral therapy (HR = 2.89, P < 0.001) were significantly associated with AFP normalization. Of the 16 (12.9%) patients who developed HCC, hepatitis B virus infection (HR = 10.82, P = 0.001), initiation of antiviral treatment postenrollment (HR = 0.23, P = 0.030), and AFP normalization within 12 months (HR = 0.13, P = 0.011) were associated with HCC development.CHB and CHC were the most common causes of falsely elevated AFP (>100 ng/mL). With either CHB or CHC, persistent AFP elevation (>12 months), regardless of antiviral treatment, might be an important marker of HCC development.


PMID:28079817DOI:10.1097/MD.0000000000005844

Rank: 8Rank: 8

现金
62111 元 
精华
26 
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30441 
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2009-10-5 
最后登录
2022-12-28 

才高八斗

发表于 2017-1-13 18:49 |显示全部帖子
医学(巴尔的摩)。 2017 Jan; 96(2):e5844。 doi:10.1097 / MD.0000000000005844。
乙型和丙型肝炎病毒感染的临床特征,具有高甲胎蛋白水平,但不是肝细胞癌。
Kim CY1,Kim BR,Lee SS,Jeon DH,Lee CM,Kim WS,Cho HC,Kim JJ,Lee JM,Kim HJ,Ha CY,Kim HJ,Kim TH,Jung WT,Lee OJ。
作者信息

    1庆尚国立大学医学院和庆尚国立大学医院内科的内科医学院庆州国立大学内科医学院昌原医院昌原医院科学研究所庆尚国立大学,韩国晋州。

抽象

确定肝细胞癌(HCC)的适当的甲胎蛋白(AFP)水平可以是100ng / mL;然而,没有充分研究没有HCC的患者中AFP的错误升高的临床意义。我们调查了无HCC但具有高AFP水平(100ng / mL),特别是慢性乙型肝炎(CHB)或C(CHC)的患者的临床特征和结果。样本包括124例连续的CHB患者(n = 97)或CHC(n = 27),AFP水平> 100ng / mL且在基线时无HCC。进行多变量Cox比例回归分析以确定与AFP正常化和HCC发展相关的因素。在平均52个月随访期间,具有AFP正常化的CHB患者的比例(90.7%)显着高于患者的比例(59.3%,P <0.001)。初始天冬氨酸转氨酶水平(风险比[HR] = 1.02每10 U / L增加,P = 0.021)和抗病毒治疗(HR = 2.89,P <0.001)与AFP正常化显着相关。在12个月内发生HCC,乙型肝炎病毒感染(HR = 10.82,P = 0.001),抗病毒治疗开始后(HR = 0.23,P = 0.030)和AFP正常化的16(12.9% 0.13,P = 0.011)与HCC发展相关.CHB和CHC是AFP(> 100ng / mL)错误升高的最常见原因。无论CHB或CHC,持续性AFP升高(> 12个月),无论抗病毒治疗,可能是HCC发展的重要标志。

PMID:
    28079817
DOI:
    10.1097 / MD.0000000000005844
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