肝硬度测量在分层残留肝细胞癌风险中的另外作用是由抗病

StephenW

Eur J Gastroenterol Hepatol. 2018 Jul 30. doi: 10.1097/MEG.0000000000001226. [Epub ahead of print]
Additional role of liver stiffness measurement in stratifying residual hepatocellular carcinoma risk predicted by serum biomarkers in chronic hepatitis B patients under antiviral therapy.
Song BG1, Sinn DH1, Chi S2, Kim K2, Kang W1, Gwak GY1, Paik YH1, Choi MS1, Lee JH1, Koh KC1, Paik SW1.
Author information

1
    Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine.
2
    Statistics and Data Center, Samsung Medical Center, Seoul, South Korea.

Abstract
BACKGROUND:

The risk of hepatocellular carcinoma (HCC) remains among patients who are treated with antiviral therapy (AVT). The degree of liver fibrosis has been suggested as an important biomarker to stratify the risk of developing HCC. We tested whether liver stiffness (LS) measured using transient elastography is useful over two noninvasive serum biomarkers of fibrosis [the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4)].
PATIENTS AND METHODS:

A retrospective cohort of 1014 CHB patients who were under AVT with nucleos(t)ide analogs for at least a year was analyzed. The risk of HCC development according to serum biomarkers (APRI and FIB-4) and LS was compared.
RESULTS:

The HCC risk was higher for those with a higher degree of liver fibrosis, as estimated by the LS, APRI, and FIB-4. When the two serum biomarkers were used to group the patients, the 3-year HCC incidence rates were 7.3, 3.0, and 1.3% for both high APRI (≥0.5) and FIB-4 (≥1.45) scores, either a high APRI or FIB-4 score, and both low APRI and FIB-4 scores, respectively (P<0.001). Among the 758 patients with discordant or both low APRI and FIB-4 scores, the LS value was high (>6) for a significant proportion of the patients (39.9%). The HCC risk was significantly different according to the LS value (3-year HCC incidence rate of 1.1, 2.0, and 6.8% for LS <6, 6-9, and >9, respectively, P<0.001).
CONCLUSION:

Among CHB patients under AVT, LS could stratify risk for HCC, including patients with discordant or both low APRI and FIB-4 score. This finding indicates that LS measurement plays an additional role over the serum biomarkers in stratifying the residual risk of HCC.

PMID:
    30063482
DOI:
    10.1097/MEG.0000000000001226

StephenW

Eur J Gastroenterol Hepatol。 2018年7月30日doi：10.1097 / MEG.0000000000001226。 [提前打印]
肝硬度测量在分层残留肝细胞癌风险中的另外作用是由抗病毒治疗的慢性乙型肝炎患者的血清生物标志物预测。
Song BG1，Sinn DH1，Chi S2，Kim K2，Kang W1，​​Gwak GY1，Paik YH1，Choi MS1，Lee JH1，Koh KC1，Paik SW1。
作者信息

1
    成均馆大学医学院三星医疗中心医学系。
2
    统计和数据中心，三星医疗中心，韩国首尔。

抽象
背景：

肝细胞癌（HCC）的风险仍然是接受抗病毒治疗（AVT）治疗的患者。肝纤维化程度已被认为是分层发生HCC风险的重要生物标志物。我们测试了使用瞬时弹性成像测量的肝硬度（LS）是否可用于纤维化的两种非侵入性血清生物标志物[天冬氨酸氨基转移酶与血小板比率指数（APRI）和纤维化-4（FIB-4）]。
患者和方法：

对具有核苷（t）ide类似物的AVT患者至少一年的1014名CHB患者的回顾性队列进行了分析。比较了根据血清生物标志物（APRI和FIB-4）和LS发生HCC的风险。
结果：

如LS，APRI和FIB-4估计的那样，肝纤维化程度较高的患者的HCC风险较高。当两种血清生物标志物用于对患者进行分组时，高APRI（≥0.5）和FIB-4（≥1.45）得分（高APRI或高APRI）的3年HCC发生率分别为7.3％，3.0％和1.3％。 FIB-4评分，以及低APRI和FIB-4评分（P <0.001）。在758名不一致或低APRI和FIB-4评分的患者中，相当大比例的患者（39.9％）的LS值高（> 6）。根据LS值，HCC风险显着不同（3年HCC发生率分别为1.1,2.0和6.8％，LS <6,6-9和> 9，P <0.001）。
结论：

在AVT下的CHB患者中，LS可以对HCC的风险进行分层，包括不一致或低APRI和FIB-4评分的患者。这一发现表明LS测量在分层HCC残留风险方面对血清生物标志物起着额外的作用。

结论：
    30063482
DOI：
    10.1097 / MEG.0000000000001226