慢性乙型肝炎患者口服抗病毒治疗后血清M2BPGi水平及肝细胞

StephenW

Aliment Pharmacol Ther. 2018 Oct 10. doi: 10.1111/apt.15006. [Epub ahead of print]
Serum M2BPGi level and risk of hepatocellular carcinoma after oral anti-viral therapy in patients with chronic hepatitis B.
Hsu YC1,2,3,4, Jun T5, Huang YT6, Yeh ML7, Lee CL8, Ogawa S9, Cho SH6, Lin JT1,2, Yu ML7, Nguyen MH10, Tanaka Y9.
Author information

1
    Division of Gastroenterology and Hepatology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan.
2
    School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.
3
    Division of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan.
4
    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
5
    Department of Medicine, Stanford University Medical Center, Palo Alto, California.
6
    Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
7
    Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
8
    Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan.
9
    Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
10
    Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California.

Abstract
BACKGROUND:

Mac-2 binding protein glycosylation isomer (M2BPGi) is an emerging biomarker for risk prediction of liver disease, but data remain sparse for patients with chronic hepatitis B (CHB) who are treated with nucleos(t)ide analogues (NA).
AIM:

To clarify serial changes in M2BPGi and its association with subsequent hepatocellular carcinoma (HCC) development in NA-treated CHB patients.
METHODS:

We enrolled 384 previously untreated CHB patients who received NAs. Among them, 195 had baseline cirrhosis (n = 142:48:5 for Child A:B:C). Sera were collected at NA initiation, and after 1 and 2 years. Serum M2BPGi levels were measured and expressed as cut-off index (COI) at different time points. The association between M2BPGi and HCC was evaluated by the Cox proportional hazard model.
RESULTS:

The median M2BPGi levels significantly decreased from 1.68 COI at baseline, to 1.0 at year 1, and 0.88 at year 2. During median follow-up of 72.7 months, HCC occurred in 37 patients, 36 of whom had cirrhosis. In patients with cirrhosis, baseline M2BPGi level was associated with HCC risk (adjusted hazard ratio, 1.07 per COI; 95% CI, 1.01-1.14) on the multivariable Cox analysis, whereas levels at year 1 or 2 were not independently predictive. A risk score for HCC was developed using baseline M2BPGi, age and body mass index with c statistics of 0.77, 0.79 and 0.87 at 3, 5 and 10 years, respectively.
CONCLUSIONS:

Serum M2BPGi level significantly decreases after NA treatment in CHB patients. Baseline level can be factored into the risk prediction of HCC in NA-treated patients with cirrhosis.

© 2018 John Wiley & Sons Ltd.

PMID:
    30306612
DOI:
    10.1111/apt.15006

StephenW

Aliment Pharmacol Ther。 2018年10月10日doi：10.1111 / apt.15006。 [提前打印]
慢性乙型肝炎患者口服抗病毒治疗后血清M2BPGi水平及肝细胞癌风险
Hsu YC1,2,3,4，Jun T5，Huang YT6，Yeh ML7，Lee CL8，Ogawa S9，Cho SH6，Lin JT1,2，Yu ML7，Nguyen MH10，Tanaka Y9。
作者信息

1
    台湾新北市辅仁天主教大学医院消化内科和肝病科。
2
    台湾新北市辅仁天主教大学医学院医学院。
3
    台湾高雄市E-Da医院消化内科和肝病科。
4
    中国医科大学临床医学研究所，台湾台中。
五
    加利福尼亚州帕洛阿尔托斯坦福大学医学中心医学系。
6
    中国科学院统计科学研究所，台湾台北。
7
    台湾高雄市高雄医科大学高雄医科大学附属医院内科，肝胆科
8
    台湾台北国泰总医院内科
9
    日本名古屋市名古屋市立大学医学研究科病毒学与肝科。
10
    加利福尼亚州帕洛阿尔托斯坦福大学医学中心消化内科和肝病学系。

抽象
背景：

Mac-2结合蛋白糖基化异构体（M2BPGi）是用于肝病风险预测的新兴生物标志物，但对于用核苷（酸）类似物（NA）治疗的慢性乙型肝炎（CHB）患者的数据仍然很少。
目标：

阐明M2BPGi的连续变化及其与NA治疗的CHB患者中随后的肝细胞癌（HCC）发展的关系。
方法：

我们招募了384名接受过NA的既往未治疗的CHB患者。其中，195例有基线肝硬化（儿童A：B：C，n = 142：48：5）。在NA开始时收集血清，并在1和2年后收集。测量血清M2BPGi水平并表示为在不同时间点的截止指数（COI）。通过Cox比例风险模型评估M2BPGi和HCC之间的关联。
结果：

中位M2BPGi水平从基线时的1.68 COI显着下降至第1年的1.0和第2年的0.88。在中位随访72.7个月期间，HCC发生在37例患者中，其中36例患有肝硬化。在肝硬化患者中，基线M2BPGi水平与多变量Cox分析的HCC风险（校正风险比，每COI 1.07; 95％CI，1.01-1.14）相关，而第1年或第2年的水平不是独立预测的。使用基线M2BPGi，年龄和体重指数开发HCC的风险评分，在3年，5年和10年分别具有0.77,0.79和0.87的c统计量。
结论：

在CHB患者中NA治疗后，血清M2BPGi水平显着降低。在NA治疗的肝硬化患者中，基线水平可以作为HCC风险预测的因素。

©2018 John Wiley＆Sons Ltd.

结论：
    30306612
DOI：
    10.1111 / apt.15006