抗病毒治疗对慢性乙型肝炎肝细胞癌发展风险预测模型的影

StephenW

Impact of antiviral therapy on risk prediction model for hepatocellular carcinoma development in patients with chronic hepatitis B
Hye Yeon Chon  1   2 , Jae Seung Lee  1   3   2 , Hye Won Lee  1   3   2 , Ho Soo Chun  1   2 , Beom Kyung Kim  1   3   2 , Jun Yong Park  1   3   2 , Do Young Kim  1   3   2 , Sang Hoon Ahn  1   3   2 , Seung Up Kim  1   3   2
Affiliations
Affiliations

    1
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
    2
    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
    3
    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.

    PMID: 33242365 DOI: 10.1111/hepr.13600

Abstract

Aim: Risk prediction models for hepatocellular carcinoma (HCC) development are available. However, the influence of antiviral therapy (AVT) on these models in patients with chronic hepatitis B (CHB) is unknown.

Methods: The dynamic changes in risk prediction models during AVT and the association between risk prediction model and the risk of CHB-related HCC development were investigated. Between 2005 and 2017, 4,917 patients with CHB (3,361 non-cirrhotic, 1,556 cirrhotic) were recruited.

Results: The mean age of the study population was 49.3 years and 60.6% (n=2,980) of the patients were male. The mean Chinese University-HCC (CU-HCC) score was 12.7 at baseline in the overall study population, and decreased significantly (mean, 8.7) after 1 year of AVT (p<0.001). The score was maintained throughout 5 years of AVT (mean, 8.4-8.8; p>0.05). The proportion of high-risk patients (CU-HCC score ≥ 20) was 28.9% at baseline, and decreased significantly after 1 year of AVT (5.0%; p<0.001), and remained stable through 5 years of AVT (2.2-3.6%; p>0.05). In addition to the score at baseline, the CU-HCC score at 1 year of AVT independently predicted the risk of HCC development (hazard ratio=1.072; p<0.001), together with male gender and platelet count (all p<0.05).

Conclusions: The CU-HCC score significantly decreased at 1 year of AVT and was maintained thereafter. The CU-HCC score after 1 year of AVT independently predicted the risk of HCC development in patients with CHB.

Keywords: Antiviral therapy; Chronic hepatitis B; Hepatocellular carcinoma; Risk prediction model.

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StephenW

抗病毒治疗对慢性乙型肝炎肝细胞癌发展风险预测模型的影响
Hye Yeon Chon 1 2，Jae Seung Lee 1 3 2，Hye Won Lee 1 3 2，Ho Soo Chun 1 2，Beom Kyung Kim 1 3 2，Jun Yong Park 1 3 2，Do Young Kim 1 3 2，Sang Hoon Ahn 1 3 2，金承Up 1 3 2
隶属关系
隶属关系

    1个
    延世大学医学院内科，韩国首尔。
    2
    大韩民国首尔遣散医院延世肝脏中心。
    3
    延世大学医学院胃肠病研究所，韩国首尔。

    PMID：33242365 DOI：10.1111 / hepr.13600

抽象

目的：可获得肝细胞癌（HCC）发展的风险预测模型。但是，在慢性乙型肝炎（CHB）患者中抗病毒治疗（AVT）对这些模型的影响尚不清楚。

方法：研究AVT期间风险预测模型的动态变化以及风险预测模型与CHB相关HCC发展风险之间的关系。在2005年至2017年之间，招募了4,917例CHB患者（3,361例非肝硬化，1,556例肝硬化）。

结果：研究人群的平均年龄为49.3岁，其中60.6％（n = 2,980）是男性。在整个研究人群中，中国大学-HCC（CU-HCC）平均得分在基线时为12.7，在AVT一年后显着下降（平均值8.7）（p <0.001）。在AVT的整个5年中均保持评分（平均值8.4-8.8； p> 0.05）。基线时，高危患者（CU-HCC评分≥20）的比例为28.9％，在AVT 1年后显着下降（5.0％； p <0.001），并且在5年AVT期间保持稳定（2.2-3.6） ％； p> 0.05）。除了基线评分外，AVT 1年时的CU-HCC评分也独立预测了HCC发生的风险（危险比= 1.072； p <0.001），以及男性和血小板计数（所有p <0.05）。

结论：AVT 1年时CU-HCC评分显着降低，此后一直保持。 AVT 1年后的CU-HCC评分独立预测了CHB患者发生HCC的风险。

关键字：抗病毒治疗；慢性乙型肝炎；肝细胞癌；风险预测模型。

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