AASLD2019[650]血清肝炎B核心相关抗原（HBCRAG） 预测肝细胞癌 慢

StephenW

650
SERUM HEPATITIS B CORE-RELATED ANTIGEN (HBCRAG)
LEVEL PREDICTS HEPATOCELLULAR CARCINOMA IN
PATIENTS WITH CHRONIC HEPATITIS B
Grace L Wong1, Lilian Yan Liang2, Hidenori Toyoda3, Henry Lik
Yuen Chan4, Yee-Kit Tse1, Terry Cheuk-Fung Yip5, Becky W.Y.
Yuen6, Toshifumi Tada3, Takashi Kumada7 and Vincent Wai-
Sun Wong4, (1)Institute of Digestive Disease, Department of
Medicine and Therapeutics, The Chinese University of Hong
Kong, (2)Department of Medicine and Therapeutics, Institute
of Digestive Disease, The Chinese University of Hong Kong,
(3)Department of Gastroenterology, Ogaki Municipal Hospital,
(4)Institute of Digestive Disease, Department of Medicine
and Therapeutics, and State Key Laboratory of Digestive
Disease, The Chinese University of Hong Kong, Hong Kong,
(5)Department of Medicine and Therapeutics, Institute of
Digestive Disease, The Chinese University of Hong Kong,
Hong Kong, (6)Department of Statistics, The Chinese
University of Hong Kong, (7)Department of Nursing, Gifu
Kyoritsu University
Background: Previous studies suggested that high
serum HBcrAg level is associated with the development of
hepatocellular carcinoma (HCC) in untreated CHB patients
We aimed to evaluate the role of serum HBcrAg levels to
predict HCC in nucleos(t)ide analogues (NA) treated patients
Methods: NA-treated CHB patients with pre-treatment serum
samples available were recruited Pre-treatment serum HBsAg
and HBcrAg and levels were measured Primary endpoint was
HCC Results: 1,424 CHB patients (mean age 54 ± 12 years,
72% male, 81% entecavir-treated and 27% tenofovir-treated,
25% HBeAg positive) were included The mean baseline
serum HBV DNA, HBsAg and HBcrAg levels were 3.99 ± 2.30
log10 IU/mL, 2 9 ± 0 9 log10 IU/mL, and 4 2 ± 1 3 log10 U/mL,
respectively 88 patients developed HCC during a follow-up of
45 ± 20 months Serum HBcrAg level above 2 9 log10 IU/mL
was an independent risk factor of HCC (adjust hazard ratio
2 83, 95% CI 1 39-5 78, p=0 004), in addition to male gender,
advanced age, low platelet count and low serum albumin
level. In contrast, HBeAg and HBV DNA at baseline were not
associated with HCC HBcrAg level remained an independent
risk factor in the subgroup of patients with negative HBeAg, or
low serum HBV DNA < 2,000 IU/mL at baseline. Conclusion:
High baseline serum HBcrAg level predicts higher risk of HCC
in NA-treated patients.

StephenW

650
血清肝炎B核心相关抗原（HBCRAG）
预测肝细胞癌
慢性乙型肝炎患者
黄恩典1，严良莲2，丰田秀田3，李家祥
袁赞4，谢洁洁1，叶国锋5，贝Beck琪
Yuen6，Toshifumi Tada3，Takashi Kumada7和Vincent Wai-
Sun Wong4，（1）消化科，消化科
香港中文大学医学与治疗学
Kong（2）研究所医学与治疗学系
香港中文大学消化系统疾病研究所
（3）大垣市立医院消化内科
（4）医学部消化疾病研究所
和治疗学，消化系统国家重点实验室
疾病，香港中文大学，香港，
（5）研究所医学与治疗学系
香港中文大学消化系统疾病
香港（6）中国统计局
香港大学（7）岐阜市护理学系
共立大学
背景：以前的研究表明
血清HBcrAg水平与糖尿病的发生有关
未治疗的CHB患者的肝细胞癌（HCC）
我们旨在评估血清HBcrAg水平对
预测接受核苷酸（t）ide类似物（NA）治疗的患者的HCC
方法：NA治疗的CHB患者接受治疗前血清
收集可用样品进行治疗前血清HBsAg
并测量HBcrAg和水平
HCC结果：1,424名CHB患者（平均年龄54±12岁，
男性72％，恩替卡韦治疗81％，替诺福韦治疗27％，
包括25％的HBeAg阳性）
血清HBV DNA，HBsAg和HBcrAg水平为3.99±2.30
log10 IU / mL，2 9±0 9 log10 IU / mL和4 2±1 3 log10 U / mL，
在随访期间分别有88例患者发生了HCC
45±20个月血清HBcrAg水平高于2 9 log10 IU / mL
是肝癌的独立危险因素（调整危险比
2 83，95％CI 1 39-5 78，p = 0 004），除了男性，
高龄，低血小板计数和低血清白蛋白
水平。相反，基线时的HBeAg和HBV DNA不
与HCC相关的HBcrAg水平仍是独立的
HBeAg阴性患者亚组中的危险因素，或
基线时血清HBV DNA低至<2,000 IU / mL。结论：
基线血清HBcrAg水平高可预示肝癌风险增加
在NA治疗的患者中。