肝纤维化肝硬化的肝硬化与HBV相关性肝硬化患者肝细胞癌的

StephenW

Hepatology International

May 2017, Volume 11, Issue 3, pp 268–276
Subcirrhotic liver stiffness by FibroScan correlates with lower risk of hepatocellular carcinoma in patients with HBV-related cirrhosis

    Authors
    Authors and affiliations

    Mi Young JeonHye Won LeeSeung Up KimEmail authorJa Yoon HeoSojung HanBeom Kyung KimJun Yong ParkDo Young KimSang Hoon AhnKwang-Hyub Han

    Mi Young Jeon        1   
     Hye Won Lee        1
    Seung Up Kim        123Email author
    Ja Yoon Heo        1
    Sojung Han        1
    Beom Kyung Kim        123
    Jun Yong Park        123
    Do Young Kim        123
    Sang Hoon Ahn        123
    Kwang-Hyub Han        123

    1.Department of Internal MedicineYonsei University College of MedicineSeoulKorea
    2.Institute of GastroenterologyYonsei University College of MedicineSeoulKorea
    3.Liver Cirrhosis Clinical Research CenterSeoulKorea

Original Article

First Online:
    21 February 2017

DOI: 10.1007/s12072-017-9789-y

Cite this article as:
    Jeon, M.Y., Lee, H.W., Kim, S.U. et al. Hepatol Int (2017) 11: 268. doi:10.1007/s12072-017-9789-y

    142 Downloads

Abstract
Background and Aims

The risk of developing hepatocellular carcinoma (HCC) varies, even in the context of cirrhosis. We investigated the relationship between liver stiffness (LS) in subcirrhotic range, assessed via transient elastography (TE), and risk of HCC development in patients with chronic hepatitis B (CHB)-related cirrhosis.
Methods

Data on 540 patients presenting with clinically evident CHB-related cirrhosis between April 2006 and December 2014 were reviewed retrospectively. Subcirrhotic range of LS was defined by TE values ≤13 kPa.
Results

Of the study population, 214 (39.6%) had LS values in the subcirrhotic range. During follow-up (median 54.1 months), 81 patients (15.0%) developed HCC. In conjunction with age, male gender, and diabetes mellitus, subcirrhotic LS value (hazard ratio = 0.462) was an independent predictor of HCC development on multivariate analysis (all p < 0.05). Cumulative HCC incidence was significantly lower for patients in subcirrhotic (versus cirrhotic) LS range (log-rank test, p < 0.05). In our cohort, the modified REACH-B score performed better than other prediction models, namely REACH-B, CU-HCC, and LSM-HCC scoring systems (area under receiver operating characteristic curve: 0.717 versus 0.669, 0.578, and 0.624, respectively, for 7-year HCC risk).
Conclusions

A significant association between subcirrhotic range of LS value and lower risk of HCC development was identified in patients with clinically evident CHB-related cirrhosis. Thus, different TE-based HCC surveillance strategies may be required even in patients with identical liver cirrhosis disease category.
Keywords
Chronic hepatitis B Hepatocellular carcinoma Liver cirrhosis Liver stiffness Transient elastography

StephenW

肝病国际

2017年5月，第11卷，第3期，第268-276页
肝纤维化肝硬化的肝硬化与HBV相关性肝硬化患者肝细胞癌的风险降低有关

    作者
    作者和附属机构

    Mi Young JeonHye Won LeeSeung Up KimEmail作者Ja Yoon HeoSojung HanBeom Kyung KimJun Yong ParkDo Young KimSang Hoon AhnKwang-Hyub Han

    米青全1
     李惠荣1
    电子邮件作者
    Ja Yoon Heo 1
    韩国韩1
    Beom Kyung Kim 123
    俊永公园123
    小金金123
    Sang Hoon Ahn 123
    Kwang-Hyub Han 123

    延安大学医学院内科系
    延迟大学医学院胃肠病学研究所韩国
    肝硬化临床研究中心韩国

来源文章

首先在线：
    2017年2月21日

DOI：10.1007 / s12072-017-9789-y

引用本文：
    Jeon，M.Y.，Lee，H.W.，Kim，S.U。 et al。 Hepatol Int（2017）11：268. doi：10.1007 / s12072-017-9789-y

    142下载

抽象
背景与目标

发生肝细胞癌（HCC）的风险即使在肝硬化的背景下也不尽相同。我们调查了通过短暂弹性成像（TE）评估的肝硬化范围内的肝硬化（LS）与慢性乙型肝炎（CHB）相关性肝硬化患者HCC发展的风险之间的关系。
方法

回顾性分析了2006年4月至2014年12月间共有540例临床证实CHB相关性肝硬化患者的资料。 LS的肝硬化范围由TE值≤13kPa定义。
结果

在研究人群中，214例（39.6％）在肝硬化范围内具有LS值。随访期间（54.1个月），81例（15.0％）发生HCC。结合年龄，男性和糖尿病，肝硬化LS值（风险比= 0.462）是多因素分析中HCC发展的独立预测因子（均P <0.05）。肝硬化（与肝硬化）LS范围的患者累积HCC发生率明显降低（log-rank检验，p <0.05）。在我们的队列中，改进的REACH-B评分表现优于其他预测模型，即REACH-B，CU-HCC和LSM-HCC评分系统（受试者操作特征曲线下面积分别为0.717和0.669,0.578,0.624） ，7年HCC风险）。
结论

临床上明显的CHB相关性肝硬化患者中确定了LS值的肝硬化范围和HCC发展风险降低之间的显着相关性。因此，即使在具有相同肝硬化疾病类别的患者中也可能需要不同的基于TE的HCC监测策略。
关键词
慢性乙型肝炎肝细胞肝肝硬化肝硬度瞬态弹性成像