年龄和性别对乙型肝炎表面抗原血清白血病肝细胞癌风险的

StephenW

Impact of age and gender on risk of hepatocellular carcinoma after hepatitis B surface antigen seroclearance
Article · June 2017
DOI: 10.1016/j.jhep.2017.06.019

    Terry Cheuk-Fung Yip
        17.46 · The Chinese University of Hong Kong
    Henry LY Chan
        51.08 · The Chinese University of Hong Kong
    Vincent Wai-Sun Wong
        49.62 · The Chinese University of Hong Kong
    Grace Wong
   University of Hong Kong

Abstract
Background and Aims Previous studies suggested spontaneous seroclearance of hepatitis B surface antigen (HBsAg) after 50 years old was still associated with an increased risk of hepatocellular carcinoma (HCC). This study aimed to evaluate the risk of HCC after HBsAg seroclearance and the impact of gender on HCC. Methods All chronic hepatitis B patients under medical care in Hospital Authority, Hong Kong who have cleared HBsAg from January 2000 to August 2016 were identified. The age of HBsAg seroclearance, gender, and subsequent development of HCC were captured and analyzed. Results 4,568 patients with HBsAg seroclearance were identified; 793 (17.4%) were treated by nucleos(t)ide analogues and 60 (1.3%) had received interferon treatment. At a median (interquartile range) follow-up of 3.4 (1.5–5.0) years, 54 patients developed HCC; cumulative incidence of HCC at 1, 3 and 5 years were 0.9%, 1.3% and 1.5%, respectively. Age above 50 years (adjusted hazard ratio 4.31, 95% confidence interval 1.72 – 10.84; P=0.002) and male gender (2.47, 1.24 – 4.91; P=0.01) were two independent risk factors of HCC. Female patients aged ≤50 years (n=545) had zero risk of HCC in 5 years. Male patients aged ≤50 years (n=769), female patients aged >50 years (n=1,149) and male patients aged >50 years (n=2,105) had a 5-year cumulative incidence of HCC 0.7%, 1.0% and 2.5%, respectively. Similar findings were observed in patients with spontaneous and antiviral treatment-induced HBsAg seroclearance. Conclusions Female patients aged 50 years or below have zero risk of HCC after HBsAg seroclearance, whereas female patients aged above 50 years and all male patients are still at risk of HCC.

StephenW

年龄和性别对乙型肝炎表面抗原血清白血病肝细胞癌风险的影响
文章·2017年6月
DOI：10.1016 / j.jhep.2017.06.019

    蔡卓凤
        17.46·香港中文大学
    陈奕迅
        51.08·香港中文大学
    王文伟
        49.62·香港中文大学
    恩典王
   香港大学

抽象
背景与目的以前的研究表明，50岁以后乙型肝炎表面抗原（HBsAg）的自发血清学仍然与肝细胞癌（HCC）风险增加有关。本研究旨在评估HBsAg血清清除后HCC的风险和性别对HCC的影响。方法确定了2000年1月至2016年8月期间清洁HBsAg的香港医院管理局所有在医疗护理下的慢性乙型肝炎病人。对HBsAg血清学，性别及其后发展的年龄进行了分析和分析。结果确定了4,568例HBsAg血清白血病患者; 793（17.4％）用核苷（t）ide类似物治疗，60例（1.3％）接受干扰素治疗。在3.4（1.5-5.0）年的中位数（四分位数范围）随访中，54例发生HCC; 1,3和5年HCC累积发生率分别为0.9％，1.3％和1.5％。 50岁以上（调整风险比4.31,95％置信区间1.72 - 10.84; P = 0.002）和男性（2.47,1.24 - 4.91; P = 0.01）是HCC的两个独立危险因素。年龄≤50岁（n = 545）的女性患者在5年内无HCC风险。年龄≤50岁的男性（n = 769），年龄≥50岁的女性患者（n = 1,149）和男性50岁以上（n = 2,105）的患者HCC累积发生率为0.7％，1.0％， 2.5％。在自发和抗病毒治疗诱导的HBsAg血清白血病患者中观察到类似的发现。结论50岁以上的女性患者HBsAg血清白血病患者HCC无风险，50岁以上女性患者和所有男性患者仍然存在HCC风险。

疯一点好

所有报道都是认定表面抗原消失并没有降低hcc风险，，所以还有必要追求转阴吗？

neilhbver

回复 疯一点好 的帖子

回去重新学习去，10岁转阴和70岁转阴，肝脏能一样吗？hcc风险能一样嘛

neilhbver

回复 疯一点好 的帖子

人类基因组里有10%是病毒基因，人类本身就是生物大杂烩。如果乙肝最终能跟人和平共处，不治疗也可以。问题就是最终还是会损害肝脏，所以还是以健康为标准，转阴不是目的，要看肝脏是否受损害了。

StephenW

回复 疯一点好 的帖子

年龄≤50岁的男性（n = 769），年龄≥50岁的女性患者（n = 1,149）和男性50岁以上（n = 2,105）的患者5年HCC累积发生率为0.7％，1.0％， 2.5％.

0.7% 是很低. 0％是不合理的.

StephenW

http://freepdfhosting.com/51930913bd.pdf?platform=hootsuite