核苷类似物治疗延缓了HBV相关肝硬化患者肝细胞癌的发病

StephenW

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        Oncotarget. 2017 May 22;8(57):96725-96731. doi: 10.18632/oncotarget.18075. eCollection  2017 Nov 14.
Nucleoside analogs treatment delay the onset of hepatocellular carcinoma in patients with HBV-related cirrhosis.Bi J1, Zhang Z1, Qin E2, Hou J1, Liu S3, Liu Z4, Li S3, Wei Z1, Zhong Y5.
Author information
1Research Center for Clinical and Translational Medicine, 302 Hospital, Beijing, 100039, China.2Infectious Disease Treatment Center, 302 Hospital, Beijing, 100039, China.3Medical Department, 302 Hospital, Beijing, 100039, China.4Medical Department, XingLong Hospital of TCM, Beijing, 100039, China.5Institute of Infectious Disease, Pediatric Liver Disease Therapy and Research Center, 302 Hospital, Beijing, 100039, China.

AbstractWhether Nucleos(t)ide analogs(NA) treatment can delay the onset of HCC remains unclear. We retrospectively analyzed the clinical data of patients with HBV-related cirrhosis and HCC from 2000 to 2012. Cox proportional hazards model was used to explore the association between NA treatment and postponement of HCC development, the dependent variable was time interval from cirrhosis treatment towards the onset of HCC, and the covariates included age, sex, family history, compensation status at baseline. A total of 1155 HCC patients treated with NAs (n = 528, lamivudine, adefovir, entecavir) and non NA (n = 627) for more than 24 months before the occurrence of HCC were incorporated into the cohort. Compared with the non-NA group, NAs therapy was associated with delaying the onset of HCC in patients with cirrhosis. Significant factors were: adefovir treatment (n = 181; p = 0.0072; HR: 0.792; 90% CI: 0.687-0.914), entecavir treatment (n = 83; p = 0.0068; HR: 0.716; 90% CI: 0.585-0.877), lamivudine switched to adefovir treatment (n = 95, p = 0.0808; HR: 0.822; 90% CI: 0.684 to 0.989). But Lamivudine monotherapy was not a significant factor (n = 102; p = 0.6877; HR: 1.045; 90% CI: 0.873-1.250). Long-term NA treatment (> 6 months, except for lamivudine monotherapy) can delay the onset of HCC in patients with HBV-related cirrhosis, and applying high barrier NA to resistance is important in these patients.


KEYWORDS: cirrhosis; hepatitis B; hepatocellular carcinoma; nucleoside analogs

PMID:29228565PMCID:PMC5722517DOI:10.18632/oncotarget.18075

StephenW

Oncotarget。 2017年5月22日; 8（57）：96725-96731。 doi：10.18632 / oncotarget.18075。 eCollection 2017年11月14日。
核苷类似物治疗延缓了HBV相关肝硬化患者肝细胞癌的发病。
Bi J1，Zhang Z1，Qin E2，Hou J1，Liu S3，Liu Z4，Li S3，Wei Z1，Zhong Y5。
作者信息

1
    北京302医院临床和转化医学研究中心，100039
2
    北京302医院感染性疾病治疗中心，100039
3
    北京市302医院医务部，100039
4
    北京市兴隆中医医院内科，北京100039
五
    北京市302医院小儿肝病治疗研究中心传染病研究所，100039

抽象

Nucleos（t）ide类似物（NA）治疗是否能延缓HCC的发病尚不清楚。回顾性分析2000〜2012年HBV相关性肝硬化和HCC患者的临床资料。应用Cox比例风险模型探讨NA治疗与HCC发展延迟的相关性，因变量为肝硬化治疗至HCC的时间间隔发生HCC，协变量包括年龄，性别，家族史，基线时的补偿状况。在HCC发生前超过24个月，共有1155例HCC患者接受NAs治疗（n = 528，拉米夫定，阿德福韦，恩替卡韦）和非NA（n = 627）。与非NA组相比，NAs治疗与延缓肝硬化患者发生HCC的发生有关。显着的因素是：阿德福韦治疗（n = 181; p = 0.0072; HR：0.792; 90％CI：0.687-0.914），恩替卡韦治疗（n = 83; p = 0.0068; HR：0.716; 90％CI：0.585-0.877 ），拉米夫定转为阿德福韦治疗（n = 95，p = 0.0808; HR：0.822; 90％CI：0.684至0.989）。但拉米夫定单药治疗不是一个重要因素（n = 102; p = 0.6877; HR：1.045; 90％CI：0.873-1.250）。长期NA治疗（> 6个月，拉米夫定单药治疗除外）可以延缓HBV相关性肝硬化患者发生HCC，对这些患者应用高阻抗NA抗药性很重要。
关键词：

肝硬化;乙肝;肝细胞癌;核苷类似物

结论：
    29228565
PMCID：
    PMC5722517
DOI：
    10.18632 / oncotarget.18075