恩替卡韦或替诺福韦治疗乙型肝炎e抗原丢失后肝细胞癌的预

StephenW

Predictive score for hepatocellular carcinoma after hepatitis B e antigen loss in patients treated with entecavir or tenofovir
Tae Seop Lim
Hyun Woong Lee
Jung Il Lee
In Hee Kim
Chang Hun Lee
Byoung Kuk Jang
Woo Jin Chung
Hyung Joon Yim
Sang Jun Suh
Yeon Seok Seo
Han Ah Lee
Jung Hwan Yu
… See all authors
First published: 07 May 2020
https://doi.org/10.1111/jvh.13316

Tae Seop Lim and Hyun Woong Lee equally contributed to this work.

Funding information:

This work was in part supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation.
Sections
PDFPDF
Tools
Share
Abstract

The risk of developing hepatocellular carcinoma (HCC) after hepatitis B e antigen seroclearance (ESC) remains unclear. We established and validated a new risk prediction model for HCC development after ESC in patients with chronic hepatitis B (CHB) receiving antiviral therapy (AVT). Between 2006 and 2016, 769 patients (training cohort) and 1,061 patients (validation cohort) with CHB who experienced ESC during AVT using entecavir (ETV) or tenofovir disoproxil fumarate (TDF) were recruited. In the multivariate analysis, male sex (hazard ratio [HR] = 2.092; 95% confidence interval [CI] = 1.152‐3.800), cirrhosis (HR = 5.141; 95% CI = 2.367‐11.167) and fibrosis‐4 index (FIB‐4) of >3.25 (HR = 2.070; 95% CI = 1.184‐3.620) were the independent risk factors for HCC development (all P  < .05). Accordingly, a novel HCC‐ESCAVT model was developed (1x [sex: male = 1, female = 0] + 3x (cirrhosis = 1, noncirrhosis = 0) + 1x (FIB‐4: >3.25 = 1, ≤3.25 = 0). The cumulative risk for HCC development was significantly different among the risk groups based on the HCC‐ESCAVT category (0‐1, 2‐4 and 5 for the low‐, intermediate‐ and high‐risk groups, respectively) (overall P  < .001, log‐rank test). The area under the receiver operating characteristic curve (AUC) for predicting HCC development 3, 5 and 10 years after ESC was 0.791, 0.771 and 0.790, respectively (all P  < .05). The predictive value of the HCC‐ESCAVT model was similar in the validation cohort (AUC = 0.802, 0.774 and 0.776 at 3, 5 and 10 years, respectively; all P  < .05). Hence, we have developed and validated a new HCC‐ESCAVT model for HCC development, which includes male sex, cirrhosis and FIB‐4 of >3.25 as constituent variables.

StephenW

恩替卡韦或替诺福韦治疗乙型肝炎e抗原丢失后肝细胞癌的预测评分
泰硕林
李贤雄
李正日
在熙金
李昌勋
张国章
胡镇中
尹俊炎
桑俊秀
尹锡徐
李汉雅
郑焕玉
…查看所有作者
首次发布：2020年5月7日
https://doi.org/10.1111/jvh.13316

Tae Seop Lim和Hyun Woong Lee同样为这项工作做出了贡献。

资金信息：

这项工作得到了韩国政府（MSIT）（2019R1A2C4070136）资助的韩国国家研究基金会（NRF）资助的部分支持。资助者在研究设计，数据收集和分析，发表决定或手稿准备中没有任何作用。
栏目
PDF格式
工具类
分享
抽象

乙型肝炎e抗原血清清除（ESC）后发生肝细胞癌（HCC）的风险仍不清楚。我们建立并验证了接受抗病毒治疗（AVT）的慢性乙型肝炎（CHB）患者进行ESC后HCC发生的新风险预测模型。在2006年至2016年之间，招募了769例CHB患者（培训队列）和1,061例患者（验证队列），他们使用恩替卡韦（ETV）或替诺福韦富马酸替诺福韦酯（TDF）在AVT期间经历了ESC。在多变量分析中，男性（危险比[HR] = 2.092； 95％置信区间[CI] = 1.152-3.800），肝硬化（HR = 5.141； 95％CI = 2.367-11.167）和纤维化-4指数（FIB）大于3.25的‐4（HR = 2.070; 95％CI = 1.184‐3.620）是HCC发生的独立危险因素（所有P <.05）。因此，开发了一种新的HCC-ESCAVT模型（1x [性别：男性= 1，女性= 0] + 3x（肝硬化= 1，非肝硬化= 0）+ 1x（FIB-4：> 3.25 = 1，≤3.25= 0 ）。根据HCC-ESCAVT类别（在低，中和高风险组分别为0-1、2-4和5），在各风险组之间，肝癌发展的累积风险有显着差异（总体P <.001，对数秩检验）。预测ESC后3年，5年和10年的HCC发生的接收器工作特征曲线（AUC）下的面积分别为0.791、0.771和0.790（所有P <.05）。在验证队列中，HCC-ESCAVT模型的预测值相似（分别在3、5和10年时，AUC = 0.802、0.774和0.776；所有P <.05），因此，我们开发并验证了新的HCC用于肝癌发展的ESCAVT模型，包括男性，肝硬化和大于3.25的FIB-4作为构成变量。

StephenW

https://onlinelibrary.wiley.com/doi/full/10.1111/jvh.13316?af=R