通过减轻AFP升高的已治疗慢性乙型肝炎患者的肝损伤，可以

StephenW

Int J Clin Exp Pathol. 2019 Apr 1;12(4):1315-1323. eCollection 2019.
AFP specificity for HCC surveillance is increased by mitigating liver injury among treated chronic hepatitis B patients with elevated AFP.
Yuan G1, Zhou Y2, Liu J1, Hu C1, Huang H1, Ren Y1, Yu W1, Guo Y1, Zhang YY3, Zhou Y1.
Author information

1
    Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University Guangzhou, China.
2
    Department of Hepatobiliary Surgery, TCM-Integrated Cancer Center, Southern Medical University Guangzhou, China.
3
    HBVtech Fredrick, Maryland, MD 20874, USA.

Abstract
OBJECTIVE:

The aim of this study was to assess AFP response in chronic hepatitis B (CHB) patients with baseline positive AFP (≥7 ng/mL) who received antiviral therapy thereafter.
METHODS:

A cohort study was conducted to assess AFP response in CHB patients who had baseline positive AFP and got antiviral therapy.
RESULTS:

This retrospective study enrolled 302 antiviral-treatment-naïve CHB patients with positive AFP. After a 12-month antiviral treatment, 144 patients normalized AFP during follow-up while the rest remained AFP-positive. There were no significant differences in baseline characteristics and virologic and ALT responses to antiviral therapy between the two groups. During a mean follow-up of 34 ± 6 months, 16 patients (5.3%) in this cohort developed HCC, and 14 (8.9%) of them emerged in the AFP positive group. There was a significant difference (P=0.004) in HCC occurrence between AFP normalized and non-normalized groups after treatment. Univariate and multivariate analyses revealed that cirrhosis (HR=9.983, 95% CI=3.609-27.617, P<0.001), and non-AFP response to antiviral treatment (HR=6.517, 95% CI=1.475-28.784, P=0.013) were two independent factors associated with HCC occurrence.
CONCLUSIONS:

To our knowledge, this is the first investigator-initiated cohort study to assess the performance of on-treatment AFP in CHB patients with baseline positive AFP. In contrast to the criticism that AFP is neither sensitive nor specific, the current study has provided important evidence that on-antiviral-treatment AFP normalization is a specific protective marker for HCC in patients with HBV-related chronic liver diseases who started antiviral therapy thereafter.

IJCEP Copyright © 2019.
KEYWORDS:

AFP α-fetoprotein; Chronic hepatitis B; HCC hepatocellular carcinoma; antiviral treatment

PMID:
    31933945

StephenW

Int J临床Exp Pathol。 2019四月1; 12（4）：1315-1323。 eCollection 2019。
通过减轻AFP升高的已治疗慢性乙型肝炎患者的肝损伤，可以提高AFP对HCC监测的特异性。
袁G1，周Y2，刘J1，胡C1，黄H1，任Y1，余W1，郭Y1，张YY3，周Y1。
作者信息

1个
    广州南方医科大学南方医院传染病与肝病科
2
    广州南方医科大学中西医结合肿瘤中心肝胆外科
3
    HBVtech Fredrick，马里兰州，马里兰州20874，美国。

抽象
目的：

这项研究的目的是评估基线AFP阳性（≥7ng / mL）的慢性乙型肝炎（CHB）患者的AFP反应，此后接受抗病毒治疗。
方法：

进行了一项队列研究，以评估基线AFP阳性并接受抗病毒治疗的CHB患者的AFP反应。
结果：

这项回顾性研究招募了302名未接受过抗病毒治疗的CHB AFP阳性患者。经过12个月的抗病毒治疗后，有144例患者在随访期间使AFP恢复正常，其余患者仍保持AFP阳性。两组之间的基线特征以及抗病毒治疗的病毒学和ALT反应无显着差异。在平均随访34±6个月期间，该队列中的16例患者（5.3％）发生了HCC，其中AFP阳性组中出现了14例（8.9％）。治疗后，AFP标准化组和非标准化组之间的HCC发生率存在显着差异（P = 0.004）。单因素和多因素分析显示，肝硬化（HR = 9.983，95％CI = 3.609-27.617，P <0.001）和非AFP对抗病毒治疗的反应（HR = 6.517，95％CI = 1.475-28.784，P = 0.013）与肝癌发生有关的两个独立因素。
结论：

据我们所知，这是第一个由研究者发起的队列研究，旨在评估基线AFP阳性的CHB患者接受治疗时AFP的表现。与对AFP既不敏感也不特异性的批评相反，当前的研究提供了重要的证据，即抗病毒治疗AFP正常化是HBV相关慢性肝病患者的HCC特异性保护标志，此患者随后开始抗病毒治疗。

IJCEP版权所有©2019。
关键字：

AFP甲胎蛋白；慢性乙型肝炎； HCC肝细胞癌；抗病毒治疗

PMID：
    31933945