FIB-4和1年FIB-4值在治疗中的变化有助于确定接受恩替卡韦治疗

StephenW

Cancers (Basel). 2020 May 7;12(5). pii: E1177. doi: 10.3390/cancers12051177.
On-Treatment Changes in FIB-4 and 1-Year FIB-4 Values Help Identify Patients with Chronic Hepatitis B Receiving Entecavir Therapy Who Have the Lowest Risk of Hepatocellular Carcinoma.
Wang HW1, Lai HC1,2, Hu TH3, Su WP1, Lu SN3, Lin CH1, Hung CH3, Chuang PH1, Wang JH3, Lee MH4, Chen CH3, Peng CY1,5.
Author information

1
    Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
2
    School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
3
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
4
    Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan.
5
    School of Medicine, China Medical University, Taichung 404, Taiwan.

Abstract

Noninvasive fibrosis indices can help stratify the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving nucleos(t)ide analogue (NA) therapy. We investigated the predictive performance of on-treatment changes in FIB-4 (△FIB-4) and 1-year FIB-4 values (FIB-4 12M) for HCC risk in patients with CHB receiving entecavir therapy. We included 1325 NA-naïve patients with CHB treated with entecavir, retrospectively, from January 2007 to August 2012. A combination of △FIB-4 and FIB-4 12M was used to stratify the cumulative risk of HCC into three subgroups each in the noncirrhotic and cirrhotic subgroups with p < 0.0001 by using the log-rank test (noncirrhotic: the highest risk (n = 88): FIB-4 12M ≥ 1.58/△FIB-4 ≥ 0 (hazard ratio (HR): 40.35; 95% confidence interval (CI): 5.107-318.7; p <0.0001) and cirrhotic: the highest risk (n = 89): FIB-4 12M ≥2.88/△FIB-4 ≥0 (HR: 9.576; 95% CI: 5.033-18.22; p < 0.0001)). Patients with noncirrhotic CHB treated with entecavir who had a FIB-4 12M < 1.58 or FIB-4 12M ≥ 1.58/△FIB-4 < 0 exhibited the lowest 5-year HCC risk (0.6%). A combination of on-treatment changes in FIB-4 and 1-year FIB-4 values may help identify patients with CHB receiving entecavir therapy with the lowest risk of HCC.
KEYWORDS:

chronic hepatitis B; entecavir; fibrosis-4 (FIB-4); hepatocellular carcinoma; noninvasive fibrosis index

PMID:
    32392752
DOI:
    10.3390/cancers12051177

StephenW

癌症（巴塞尔）。 2020年5月7日； 12（5）。 pii：E1177。 doi：10.3390 / cancers12051177。
FIB-4和1年FIB-4值在治疗中的变化有助于确定接受恩替卡韦治疗的慢性乙型肝炎患者肝细胞癌风险最低。
Wang HW1，Lai HC1,2，Hu TH3，Su WP1，Lu SN3，Lin CH1，Hung CH3，Chuang PH1，Wang JH3，Lee MH4，Chen CH3，Peng CY1,5。
作者信息

1个
    中国医科大学附属医院内科消化医学中心，台湾台中404。
2
    中国医科大学中医学院，台湾台中404。
3
    高雄长庚纪念医院和长庚大学医学院内科肝消化肠内科，台湾高雄833。
4
    国立阳明大学临床医学研究所，台湾台北112。
5
    中国医科大学医学院，台湾台中404。

抽象

非侵入性纤维化指数可以帮助对接受核苷酸（t）ide类似物（NA）治疗的慢性乙型肝炎（CHB）患者进行肝细胞癌（HCC）的危险分层。我们调查了接受恩替卡韦治疗的慢性乙型肝炎患者的FIB-4（△FIB-4）和1年FIB-4值（FIB-4 12M）治疗后HCC风险的预测性能。从2007年1月至2012年8月，我们纳入了1325例使用恩替卡韦治疗的NA初治性CHB患者。将△FIB-4和FIB-4 12M的组合用于将HCC的累积风险分为非肝硬化的三个亚组。对数秩和检验的肝硬化亚组p <0.0001（非肝硬化：最高风险（n = 88）：FIB-4 12M≥1.58 /△FIB-4≥0（危险比（HR）：40.35; 95％置信区间（CI）：5.107-318.7; p <0.0001）和肝硬化：最高风险（n = 89）：FIB-4 12M≥2.88/△FIB-4≥0（HR：9.576; 95％CI：5.033- 18.22； p <0.0001））。 FIB-4 12M <1.58或FIB-4 12M≥1.58 /△FIB-4 <0的恩替卡韦治疗非肝硬化CHB患者的5年HCC风险最低（0.6％）。 FIB-4和1年FIB-4值的治疗中变化的组合可能有助于确定接受恩替卡韦治疗的CHB患者的HCC风险最低。
关键字：

慢性乙型肝炎恩替卡韦纤维化4（FIB-4）；肝细胞癌；无创纤维化指数

PMID：
    32392752
DOI：
    10.3390 /癌症12051177

StephenW

https://www.mdpi.com/2072-6694/12/5/1177