长期抗病毒治疗下肝硬化发展为肝细胞癌的预测因子

StephenW

Predictors for the progression of hepatic cirrhosis to hepatocellular carcinoma under long-term antiviral therapy

Li, Zhiqina; Hu, Yushua; Wang, Hongyana; Wang, Mengb; Gu, Xinyuc; Ping, Yud; Zeng, Qingleia; Li, Huaa; Yan, Jingyaa; Yu, ZujiangaAuthor Information
European Journal of Gastroenterology & Hepatology: March 2020 - Volume 32 - Issue 3 - p 447-453
doi: 10.1097/MEG.0000000000001631

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Abstract
Objective
Patients diagnosed with hepatitis B virus (HBV)-related hepatic cirrhosis have the potential for progression to hepatocellular carcinoma (HCC) even while undergoing long-term nucleos(t)ide analog (NA) therapy. This study investigated the predictors for the progression of hepatic cirrhosis to HCC under long-term NA therapy.
Methods
This retrospective study enrolled 898 patients diagnosed with HBV-related hepatic cirrhosis. They received NA therapy between January 2012 and January 2015. The values for the liver stiffness measurement (LSM), laboratory tests, and disease history were collected. The diagnostic specificity of the serum, was assessed with a receiver operating characteristic curve.
Results
The overall 2- and 3-year cumulative incidence of HCC was 6.8% and 15.15%, respectively. The LSM values were higher in the patients who had progressed to HCC. The serum PIVKA-II levels were more efficient than the serum AFP levels for the diagnosis of early HCC as the larger area under curve (0.866 vs. 0.687). The multivariate logistic regression analysis showed that HCC occurrence was significantly associated with the baseline LSM value (odds ratio = 1.035). At the end of the study, the death rate for the patients with larger LSM values was higher than that for those with lower LSM values (67.88% vs. 39.90%).
Conclusion
Patients with HBV-related cirrhosis have the potential for progression to HCC even under long-term NA therapy. The LSM value and the serum PIVKA-II level are significant predictors of HCC occurrence.

StephenW

长期抗病毒治疗下肝硬化发展为肝细胞癌的预测因子

李志奇娜胡玉树王洪雅娜王孟波具新玉平玉曾庆蕾李华严静雅Yu，Zujianga作者信息
《欧洲胃肠病学和肝病学杂志》：2020年3月-第32卷-第3期-第447-453页
doi：10.1097 / MEG.0000000000001631

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抽象
目的
被诊断为乙型肝炎病毒（HBV）相关性肝硬化的患者即使接受长期的核苷酸（t）类似物（NA）治疗，也有可能发展为肝细胞癌（HCC）。这项研究调查了长期NA治疗下肝硬化发展为HCC的预测因素。
方法
这项回顾性研究招募了898名被诊断为HBV相关性肝硬化的患者。他们在2012年1月至2015年1月之间接受了NA治疗。收集了肝脏硬度测量值（LSM），实验室检查和疾病史的值。用接受者的工作特征曲线评估血清的诊断特异性。
结果
肝癌的2年和3年总累积发病率分别为6.8％和15.15％。进展为肝癌的患者的LSM值较高。由于曲线下面积较大（0.866 vs. 0.687），血清PIVKA-II水平比血清AFP水平更有效地诊断早期HCC。多元逻辑回归分析显示，肝癌的发生与基线LSM值显着相关（几率= 1.035）。在研究结束时，LSM值较高的患者的死亡率高于LSM值较低的患者（67.88％vs. 39.90％）。
结论
即使长期接受NA治疗，HBV相关性肝硬化患者也有可能发展为HCC。 LSM值和血清PIVKA-II水平是HCC发生的重要预测指标。