EASL2019 THU-207 回顾性研究肝细胞癌的发病率 慢性乙型肝炎患

StephenW

THU-207
A retrospective review of the incidence of hepatocellular
carcinoma in patients with chronic hepatitis B attending the
regional hepatitis clinic in Northern Ireland
Geraldine Carroll1, Johnny Cash1, Gemma Wasson1, Conor Braniff1,
Neil McDougall1. 1Royal Victoria Hospital, Belfast, United Kingdom
Email: [email protected]
Background and aims: Hepatocellular Carcinoma (HCC) is a major
concern in patients with Chronic Hepatitis B (CHB) and may develop,
even when a patient is adequately treated. Incidence of HCC is
reported as being higher in patients with co-factors including
cirrhosis, high viral load, family history of HCC, male sex and
alcohol excess.
In Northern Ireland all Hepatitis B cases are managed at a single
regional centre.
The aim of this studywas to ascertain the incidence of HCC in the CHB
cohort attending the regional viral hepatitis clinic.
Method: Data was analysed using the regional liver unit Hepatitis B
database. This information was cross-referenced with the CHB
treatment database and Northern Ireland Electronic Care Record.
Co-infected patient were not included in this review.
Results: 1126 patients attended the Liver Unit for management of
Hepatitis B between 2009 and 2018.
15 (1.3%) were diagnosed with HCC. 12 (80%) were male. 10 patients
(67%) had established cirrhosis.
3 (20%) received transartertial chemoembolization (TACE), 2 (13%)
were transplanted and 2 (13%) underwent resection, 1 (7%) received
Sorafenib therapy, 1 (7%) underwent resection, TACE and Sorafenib
therapy,1 (7%) received ablation therapy. 5 (33%)were not suitable for
intervention.
11 (73%) are now deceased.
10 patients (67.5%) were South East Asian in ethnicity, 1 (6.5%) was
from Northern Ireland with 1 (6.5%) each from Portugal, Nigeria,
Spain and Lithuania. 4 of the 5 patients who developed HCC without
underlying cirrhosis were South East Asian men, the remaining
patient was Portuguese.
7 patients (47%) had significant viraemia of >20, 000 at the time of
diagnosis.
12 (80%) were treated with nucleotide/nucleoside analogues while
the remaining 3 (19%) were referred at an advanced stage and not
commenced on treatment. 9 (69%) of those receiving antiviral
therapy achieved complete viral suppression at their last recorded
HBV DNA PCR.
In total,147 patients received antiviral therapy, of whom49 (33%) had
cirrhosis. The incidence of HCC in this high risk group was 12 (8%).
Conclusion: The incidence of HCC in patients with CHB attending the
regional viral hepatitis clinic is 1.3% but is much higher in the
subgroup that have received antiviral therapy (8%). Significant
cofactors include male sex and South East Asian ethnicity, high
viral load and established cirrhosis.

StephenW

THU-207
回顾性研究肝细胞癌的发病率
慢性乙型肝炎患者的癌症就诊
北爱尔兰的区域性肝炎诊所
Geraldine Carroll1，Johnny Cash1，Gemma Wasson1，Conor Braniff1，
尼尔麦克杜格尔1。 1Royal维多利亚医院，英国贝尔法斯特
电子邮件：[email protected]
背景和目的：肝细胞癌（HCC）是一个主要的
关注慢性乙型肝炎（CHB）患者并可能发展，
即使患者得到充分治疗。 HCC的发病率是
据报道，患有辅因子的患者更高
肝硬化，高病毒载量，HCC家族史，男性和女性
酒精过量。
在北爱尔兰，所有乙型肝炎病例都是单一的
区域中心。
本研究的目的是确定CHB中HCC的发病率
队列参加区域病毒性肝炎诊所。
方法：使用区域性肝脏单位乙型肝炎分析数据
数据库。该信息与CHB交叉引用
治疗数据库和北爱尔兰电子护理记录。
共同感染的患者未包括在本评价中。
结果：1126名患者参加了肝脏单位的管理
2009年至2018年间乙型肝炎。
15例（1.3％）被诊断为HCC。 12（80％）是男性。 10名患者
（67％）已确诊肝硬化。
3例（20％）接受经动脉化疗栓塞（TACE），2例（13％）
移植，2例（13％）行切除术，1例（7％）接受切除术
索拉非尼治疗1例（7％）行切除术，TACE和索拉非尼治疗
治疗1例（7％）接受消融治疗。 5（33％）不适合
介入。
11人（73％）现已去世。
10名患者（67.5％）是东南亚族，1名（6.5％）
来自北爱尔兰，葡萄牙，尼日利亚各1人（6.5％）
西班牙和立陶宛。没有发生HCC的5例患者中有4例
潜在的肝硬化是东南亚男性，其余的
病人是葡萄牙人。
7名患者（47％）在发病时具有> 20,000的显着病毒血症
诊断。
12名（80％）用核苷酸/核苷类似物治疗
剩下的3个（19％）是在高级阶段被提及而不是
开始治疗。 9例（69％）接受抗病毒治疗
治疗在他们的最后记录完成病毒抑制
HBV DNA PCR。
总共有147名患者接受了抗病毒治疗，其中49名患者（33％）患有抗病毒治疗
肝硬化。该高危组的HCC发病率为12（8％）。
结论：CHB患者发生HCC的发生率高
区域性病毒性肝炎诊所为1.3％，但在该病中高得多
已接受抗病毒治疗的亚组（8％）。重大
辅助因素包括男性和东南亚种族，高
病毒载量和确定的肝硬化。