AASLD2020[739]血清乙型肝炎相關抗原的預測 日本肝細胞癌的預

StephenW

739
SERUM HEPATITIS B CORE-RELATED ANTIGEN PREDICTS
PROGNOSIS IN JAPANESE HEPATOCELLULAR CARCINOMA
PATIENTS WITH HEPATITIS B
Hitomi Takada, Shinya Maekawa, Yasuyuki Komiyama, Ryo
Katoh, Natsuko Nakakuki, Shuya Matsuda, Masaru Muraoka,
Yuichiro Suzuki, Akihisa Tatsumi, Yasuhiro Nakayama,
Taisuke Inoue and Nobuyuki Enomoto, First Department of
Internal Medicine, University of Yamanashi
Background: Serum hepatitis B core-related antigen
(HBcrAg) is a marker that reflects intrahepatic cccDNA
transcription activity, and its association with the development
of hepatocellular carcinoma (HBV-HCC) has been reported
However, there are few reports on the association between
HBcrAg and prognosis in patients with HCC We aimed to
analyze the relationship between prognosis and HBcrAg
in HCC cases with hepatitis B in this study Methods: This
study included 599 HBV-related patients who visited our
hospital and were followed up for more than 6 months In
133 patients with nucleos(t)ide analog (NA) therapy who had
a history of HCC, factors related to the survival after HCC
diagnosis were examined Results: Among total of HBVrelated
diseases, the median follow-up duration was 9 3
years, and 66 cases died during the observation period The
cause of death was development of HCC in 34, liver failure in
11, and non-liver related death in 21 cases. One hundred fifty
cases with a history of HCC during the observation period had
significantly shorter survival time compared with non-HCC
cases (p<0 001) Of the 133 HCC patients who had started
NA therapy during the clinical course, 77% was male, and
the age at HCC diagnosis was 61 (53-68) years The clinical
stages were immune clearance phase in 119 cases (HBeAg
positive in 15 and negative in 104 cases) and inactive phase
in 14 cases, and BCLC stages were A/B/C in 104/18/11
cases Factors associated with post-carcinogenic survival
in HBV-HCC cases were no seroconversion, ALBI grade 2/3
at HCC diagnosis, beyond up to seven criteria or vascular
invasion/distant metastasis, and non-achievement of cancerfree
during 6 months or more after HCC treatments, AFP
≥ 100 ng/ml or DCP 100 mAU/ml, and HBcrAg ≥ 5.0 at the
final examination, in univariate analysis. Multivariate analysis
revealed that ALBI grade 2/3 (Hazard ratio 12, p=0 052),
non-achievement of cancer-free for more than 6 months (HR
29, p=0.050), and HBcrAg ≥ 5.0 (HR 56, p=0.0043) were
independent factors Conclusion: HBcrAg may be useful
for predicting prognosis after HCC development in Japanese
hepatitis B patients.

StephenW

739
血清乙型肝炎相關抗原的預測
日本肝細胞癌的預後
乙型肝炎患者
高田瞳，前川真也，宮山康之，涼
加藤，中子夏子，松田周也，村岡雅郎，
鈴木雄一郎，辰久明久，中山康宏，
井上大輔和江本伸之
山梨大學內科
背景：血清乙肝核心相關抗原
（HBcrAg）是反映肝內cccDNA的標記
轉錄活性及其與發育的關係
肝細胞癌（HBV-HCC）的報導
但是，很少有關於
HBcrAg與肝癌患者的預後
分析預後與HBcrAg的關係
本研究中的乙肝肝癌患者中的方法：
研究包括599名與HBV相關的患者
醫院，並隨訪了6個月以上
133例接受核苷（核苷酸）類似物（NA）治療的患者
肝癌病史，與肝癌術後生存有關的因素
診斷檢查結果：HBV相關
疾病，中位隨訪時間為9 3
年，在觀察期間死亡66例。
死亡原因是34歲的肝細胞癌的發展，
11例，與非肝臟相關的死亡21例。一百五十
在觀察期內有肝癌病史的病例
與非肝癌相比，生存時間明顯縮短
133例已經開始的HCC患者中的病例（p <0 001）
臨床過程中的NA療法，其中77％為男性，
HCC診斷的年齡為61（53-68）歲
119例（HBeAg
15例為陽性，104例為陰性）和無效期
14例中，BCLC階段為104/18/11中的A / B / C
病例與致癌後存活相關的因素
HBV-HCC患者無血清學轉變，ALBI 2/3級
在HCC診斷中，超過七個標准或血管
浸潤/遠處轉移和未實現無癌
在肝癌治療後6個月或更長時間內，AFP
≥100 ng / ml或DCP 100 mAU / ml，且HBcrAg≥5.0
期末檢查，進行單變量分析。多元分析
揭示了ALBI 2/3級（危險比12，p = 0 052），
超過6個月未實現無癌（HR
29，p = 0.050）和HBcrAg≥5.0（HR 56，p = 0.0043）
獨立因素結論：HBcrAg可能有用
預測日本人肝癌發生後的預後
乙肝患者。