长期抗病毒治疗下肝硬化发展为肝细胞癌的预测指标

StephenW

Eur J Gastroenterol Hepatol. 2020 Mar;32(3):447-453. doi: 10.1097/MEG.0000000000001631.
Predictors for the progression of hepatic cirrhosis to hepatocellular carcinoma under long-term antiviral therapy.
Li Z1, Hu Y1, Wang H1, Wang M2, Gu X3, Ping Y4, Zeng Q1, Li H1, Yan J1, Yu Z1.
Author information

1
    Department of Infectious Disease.
2
    Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University.
3
    Department of Hepatopathy, the Sixth People's Hospital of Zhengzhou.
4
    Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.

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.

PMID:
    32012142
DOI:
    10.1097/MEG.0000000000001631

StephenW

Eur J胃肠肝素。 2020年3月; 32（3）：447-453。 doi：10.1097 / MEG.0000000000001631。
长期抗病毒治疗下肝硬化发展为肝细胞癌的预测指标。
李Z1，胡Y1，王H1，王M2，顾X3，平Y4，曾Q1，李H1，严J1，于Z1。
作者信息

1个
    传染病科。
2
    郑州大学第一附属医院消化内科。
3
    郑州市第六人民医院肝病科。
4
    郑州大学第一附属医院生物治疗中心，河南郑州

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。

PMID：
    32012142
DOI：
    10.1097 / MEG.0000000000001631