一大群白人患有慢性乙型肝炎的人群中，口服治療超過5年的

StephenW

J Hepatol. 2020 Jan 22. pii: S0168-8278(20)30022-2. doi: 10.1016/j.jhep.2020.01.007. [Epub ahead of print]
Hepatocellular carcinoma prediction beyond year 5 of oral therapy in a large cohort of Caucasian patients with chronic hepatitis B.
Papatheodoridis GV1, Sypsa V2, Dalekos GN3, Yurdaydin C4, Van Boemmel F5, Buti M6, Calleja JL7, Chi H8, Goulis J9, Manolakopoulos S10, Loglio A11, Voulgaris T12, Gatselis N3, Keskin O4, Veelken R5, Lopez-Gomez M7, Hansen BE13, Savvidou S9, Kourikou A14, Vlachogiannakos J12, Galanis K3, Idilman R4, Esteban R6, Janssen H15, Berg T5, Lampertico P11.
Author information
Abstract
BACKGROUND & AIMS:

Hepatocellular carcinoma (HCC) may develop in chronic hepatitis (CHB) patients even after 5 years of oral therapy and cannot be easily predicted. We assessed predictors and need for HCC surveillance in this setting.
METHODS:

Of 1951 adult Caucasians with CHB included in the PAGE-B cohort, 1427 (73%) have completed follow-up >5 years under therapy without HCC until year 5. Median follow-up has been 8.4 years from treatment onset. Points-based risk scores were developed to predict HCC risk after year 5.
RESULTS:

In years 5-12, HCC has been diagnosed in 33/1427 (2.3%) patients with cumulative incidence 2.4%, 3.2% and 3.8% at 8, 10 and 12 years, respectively. Older age or age >50 years, baseline cirrhosis and liver stiffness (LSM) ≥12 kPa at year 5 were independently associated with increased HCC risk. The HCC incidence was lower in non-cirrhotics than those with baseline cirrhosis and year-5 LSM <12 kPa than those with baseline cirrhosis and year-5 LSM ≥12 kPa. CAGE-B score was based on age at year 5 and baseline cirrhosis in relation to LSM at year 5 and SAGE-B score was based only on age and LSM at year 5 (c-index=0.809-0.814, 0.805-0.806 after bootstrap validation). Both scores offered 100% negative predictive values for HCC development in their low risk groups.
CONCLUSIONS:

In Caucasians with CHB, the HCC risk after the first 5 years of antiviral therapy depends on age, baseline cirrhosis status and LSM at year 5. CAGE-B and particularly SAGE-B represent simple and reliable risk scores for HCC prediction and surveillance beyond year 5 of therapy.

Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
KEYWORDS:

cirrhosis; entecavir; liver stiffness; tenofovir

PMID:
    31981727
DOI:
    10.1016/j.jhep.2020.01.007

StephenW

J肝素。 2020年1月22日。pii：S0168-8278（20）30022-2。 doi：10.1016 / j.jhep.2020.01.007。 [Epub提前發行]
一大群白人患有慢性乙型肝炎的人群中，口服治療超過5年的肝細胞癌預測。
Papatheodoridis GV1，Sypsa V2，Dalekos GN3，Yurdaydin C4，Van Boemmel F5，Buti M6，Calleja JL7，Chi H8，Goulis J9，Manolakopoulos S10，Loglio A11，Voulgaris T12，Gatselis N3，Keskin O4，Lo7 ，Hansen BE13，Savvidou S9，Kourikou A14，Vlachogiannakos J12，Galanis K3，Idilman R4，Esteban R6，Janssen H15，Berg T5，Lampertico P11。
作者信息
抽象
背景與目的：

即使經過5年的口服治療，慢性肝炎（CHB）患者也可能會發展為肝細胞癌（HCC），無法輕易預測。在這種情況下，我們評估了預測因素並需要進行HCC監測。
方法：

在PAGE-B隊列中包括CHB的1951年成年高加索人中，有1427名（73％）在沒有HCC的情況下接受了5年以上的隨訪，直到第5年為止。中位隨訪時間為從治療開始至8.4年。開發基於積分的風險評分以預測5年後的HCC風險。
結果：

在5至12年間，已在33/1427（2.3％）患者中診斷出HCC，分別在8、10和12年時累積發生率分別為2.4％，3.2％和3.8％。年齡大於或大於50歲，基線肝硬化和第5年肝硬化（LSM）≥12 kPa與HCC風險增加獨立相關。在非肝硬化患者中，HCC發生率低於基線肝硬化且5年LSM <12 kPa的患者，低於基線肝硬化且5年LSM≥12kPa的患者。 CAGE-B得分基於5歲時的年齡和基線肝硬化相對於LSM的5年水平，SAGE-B得分僅基於年齡和LSM的5歲時的年齡（c-index = 0.809-0.814，0.805-0.806）驗證）。這兩個分數在其低風險組中均提供了100％的HCC陰性預測值。
結論：

在患有CHB的高加索人中，抗病毒治療的前5年後，其HCC風險取決於年齡，基線肝硬化狀態和第5年的LSM。CAGE-B（尤其是SAGE-B）代表了對HCC預測和監測的簡單可靠的風險評分5療法。

版權所有©2020歐洲肝病研究協會。由Elsevier B.V.發布。保留所有權利。
關鍵字：

肝硬化恩替卡韋肝臟僵硬替諾福韋

PMID：
    31981727
DOI：
    10.1016 / j.jhep.2020.01.007