HBsAg，HBcrAg和肝细胞癌之间的关系在患者检测不到HBV DNA核苷

StephenW

J Viral Hepat. 2017 Feb 10. doi: 10.1111/jvh.12688. [Epub ahead of print]
Complete title: Relationship between HBsAg, HBcrAg and hepatocellular carcinoma in patients with undetectable HBV DNA under nucleos(t)ide therapy.Cheung KS1, Seto WK1,2, Wong DK1,2, Lai CL1,2, Yuen MF1,2.
Author information

• 1Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
• 2State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
  

AbstractWe examined the relationship between hepatitis B surface and core-related antigens (HBsAg, HBcrAg) and hepatocellular carcinoma (HCC) development in patients with undetectable serum HBV DNA receiving nucleos(t)ide analogue (NA). Seventy-six HBV carriers with undetectable HBV DNA (<20 IU/mL) who subsequently developed HCC were compared with 152 matched controls. Clinical and laboratory parameters (including novel assays to measure linearized HBsAg [HQ-HBsAg] and HBcrAg) were analyzed. There were no significant differences in HBsAg/ HQ-HBsAg levels between the two groups. There was a significant difference in the median values of both pre- and post-NA HBcrAg levels between the HCC and control groups (pre-treatment: 279.0 vs 35.4 kU/mL, p=0.005; post-treatment: 10.2 vs 1.7 kU/mL, p=0.005, respectively). For the whole HCC group, a cutoff value of post-treatment HBcrAg level ≥7.8 kU/mL yielded an area under receiver operating curve (AUROC) of 0.61 with a negative predictive value (NPV) of 77.0%. The OR of HCC development was 3.27. For non-cirrhotic patients, the median values of post-treatment HBcrAg level of HCC group and controls were 10.2 and 1.0 kU/mL respectively (p=0.001). A cutoff value of HBcrAg level ≥7.9 kU/mL yielded an AUROC of 0.70 with a NPV of 80.6%. The OR of HCC development was 5.95. A higher pre- and post-NA treatment HBcrAg level (but not HBsAg) was associated with an increased risk of HCC development in patients achieving undetectable serum HBV DNA while on NA therapy. HBcrAg may serve as a novel risk marker for HCC in this group of patients. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS: HCC; NA therapy; hepatitis B core-related antigen

PMID:28185363DOI:10.1111/jvh.12688

StephenW

J病毒Hepat。 2017年2月10日。doi：10.1111 / jvh.12688。 [印刷前电子版]
完整标题：HBsAg，HBcrAg和肝细胞癌之间的关系在患者检测不到HBV DNA核苷（t）ide治疗。
Cheung KS1，Seto WK1,2，Wong DK1,2，Lai CL1,2，Yuen MF1,2。
作者信息

    1香港大学医学院，香港玛丽医院。
    2香港大学肝脏研究国家重点实验室。

抽象

我们检查了乙型肝炎表面和核心相关抗原（HBsAg，HBcrAg）和肝细胞癌（HCC）发展的不可检测的血清HBV DNA接受核苷酸类似物（NA）之间的关系。随后发展HCC的七十六个具有不可检测的HBV DNA（<20IU / mL）的HBV载体与152个匹配的对照进行比较。分析了临床和实验室参数（包括测量线性化HBsAg [HQ-HBsAg]和HBcrAg的新测定法）。两组之间HBsAg / HQ-HBsAg水平无显着差异。在HCC和对照组之间的前和后NA HBcrAg水平的中值的中值有显着差异（治疗前：279.0对35.4kU / mL，p = 0.005;后处理：10.2对1.7kU / mL，p = 0.005）。对于整个HCC组，治疗后HBcrAg水平≥7.8kU / mL的截断值产生的受试者工作曲线下面积（AUROC）为0.61，阴性预测值（NPV）为77.0％。 HCC发展的OR为3.27。对于非肝硬化患者，HCC组和对照的治疗后HBcrAg水平的中值分别为10.2和1.0 kU / mL（p = 0.001）。 HBcrAg水平≥7.9kU / mL的截断值产生的AUROC为0.70，NPV为80.6％。 HCC发展的OR为5.95。较高的前和后NA处理HBcrAg水平（但不是HBsAg）与在NA治疗时获得不可检测的血清HBV DNA的患者中HCC发展的风险增加相关。 HBcrAg可作为这组患者中HCC的新型风险标志物。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

HCC; NA治疗;乙型肝炎核心相关抗原

PMID：
    28185363
DOI：
    10.1111 / jvh.12688