提高与慢性丙型肝炎和乙型肝炎相关的肝细胞癌患者的生存

StephenW

Intern Med J. 2019 Mar 25. doi: 10.1111/imj.14304. [Epub ahead of print]
Improving survival in patients with hepatocellular carcinoma related to chronic hepatitis C and B but not in those related to non-alcoholic steatohepatitis or alcoholic liver disease: a 20-year experience from a national programme.
Hassan I1, Gane E1.
Author information

1
    New Zealand Liver Transplant unit (NZLTU), Auckland City Hospital, Auckland, New Zealand.

Abstract
BACKGROUND:

Hepatocellular carcinoma (HCC) is the most rapidly increasing cause of cancer mortality in New Zealand due to endemic Hepatitis B (HBV) infection and recent Hepatitis C (HCV) and obesity epidemics.
METHODS:

All newly diagnosed cases of HCC referred to NZLTU between 1998 and 2017 were included. Data on patient demographics, liver disease aetiology, screening status and treatment modalities were collected.
RESULTS:

HCC diagnosis rates have increased from 24 cases in 1998 to 250 in 2017, an increase of 20% per annum. The total of 1985 HCC cases was divided into 3 cohorts (Era 1: 1998 to 2009; Era 2: 2009 to 2014; Era 3: 2014 to 2017), each comprising 661-662 patients. During the study period, overall survival improved (p=0.005). The proportion with screen-detected HCC was similar across the 3 cohorts (44% in Era 1, 42% in Era 2 and 47% in Era 3). Five and 10-year survival was higher in screen-detected cases (49% and 43%) than in non-screen detected cases (14% and 10%), p<0.0001. Survival was higher in patients with HCV and HBV than in those with NASH or ALD - 5 and 10-year survival was 40% and 34% in HCV-HCC, 30% and 26% in HBV-HCC, 15% and 14% in NASH-HCC, 13% and 10% in ALD-HCC, p<0.0001.
CONCLUSION:

Better outcomes in patients with HBV-related or HCV-related HCC than in those with NASH-related or ALD-related HCV may reflect better screening uptake and better access to curative therapies. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

HBV-related HCC; HCC surveillance; HCV-related; Hepatocellular carcinoma (HCC); NASH-related HCC

PMID:
    30908822
DOI:
    10.1111/imj.14304

StephenW

Intern Med J. 2019 Mar 25. doi：10.1111 / imj.14304。 [印刷前的电子版]
提高与慢性丙型肝炎和乙型肝炎相关的肝细胞癌患者的生存率，但不提高与非酒精性脂肪性肝炎或酒精性肝病相关的患者的生存率：来自国家计划的20年经验。
哈桑I1，Gane E1。
作者信息

1
    新西兰肝脏移植单位（NZLTU），奥克兰市医院，新西兰奥克兰。

抽象
背景：

由于地方性乙型肝炎（HBV）感染和最近的丙型肝炎（HCV）和肥胖流行，肝细胞癌（HCC）是新西兰癌症死亡率增加最快的原因。
方法：

所有新诊断的HCC病例均在1998年至2017年间提交给NZLTU。收集患者人口统计学，肝病病因学，筛查状态和治疗方式的数据。
结果：

HCC诊断率从1998年的24例增加到2017年的250例，每年增加20％。 1985年HCC病例总数分为3个队列（时代1：1998年至2009年;时代2：2009年至2014年;时代3：2014年至2017年），每个包括661-662名患者。在研究期间，总体生存率得到改善（p = 0.005）。筛查检出的HCC的比例在3个队列中相似（在时代1中为44％，在时代2中为42％，在时代3中为47％）。屏幕检测病例（49％和43％）的5年和10年生存率高于非筛查检出病例（14％和10％），p <0.0001。 HCV和HBV患者的生存率高于NASH或ALD患者 -  5年和10年生存率分别为HCV-HCC的40％和34％，HBV-HCC的30％和26％，15％和14％的患者。 NASH-HCC，ALD-HCC中13％和10％，p <0.0001。
结论：

HBV相关或HCV相关HCC患者的结果优于NASH相关或ALD相关HCV患者，可能反映更好的筛查吸收和更好的治疗方法。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

HBV相关的HCC; HCC监测; HCV相关;肝细胞癌（HCC）; NASH相关的HCC

结论：
    30908822
DOI：
    10.1111 / imj.14304