接受核苷酸/核苷類似物治療的慢性乙型肝炎患者肝細胞癌預

StephenW

Dynamic evaluation of hepatocellular carcinoma prediction models in patients with chronic hepatitis B receiving nucleotide/nucleoside analogue treatment
Sakura Kirino  1 , Nobuharu Tamaki  1 , Masayuki Kurosaki  1 , Kento Inada  1 , Koji Yamashita  1 , Shuhei Sekiguchi  1 , Yuka Hayakawa  1 , Leona Osawa  1 , Mayu Higuchi  1 , Kenta Takaura  1 , Chiaki Maeyashiki  1 , Shun Kaneko  1 , Yutaka Yasui  1 , Kaoru Tsuchiya  1 , Hiroyuki Nakanishi  1 , Jun Itakura  1 , Yuka Takahashi  1 , Namiki Izumi  1
Affiliations
Affiliation

    1
    Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.

    PMID: 33484033 DOI: 10.1111/jvh.13473

Abstract

Carcinogenesis risk scores for chronic hepatitis B have been proposed, but it remains unclear whether these scores during nucleoside/nucleotide analogue (NA) therapy are useful for risk assessment. In this study, we examined changes of these scores and the predictability during NA treatment. 432 patients with no history of hepatocellular carcinoma (HCC) treated with NA were enrolled. PAGE-B, modified PAGE-B (mPAGE-B), and REACH-B scores were calculated at NA administration, 1 and 2 years after administration.The median follow-up duration was 5.1 years, during which 37 patients (8.6%) developed HCC. Cumulative incidence HCC development in patients with high-risk of PAGE at NA administration, and 1 and 2 years after NA administration was significantly higher than those with intermediate and low- risk groups (p< 0.05 for all time points), whereas HCC incidence in patients with high-risk of mPAGE-B and REACH-B at 2 years after NA administration were equivalent to those with intermediate (p=0.2) and low-risk groups (p = 0.1). The area under the receiver operating characteristic (AUROC) for HCC development of PAGE-B at NA administration, and 1 and 2 years after administration were 0.773, 0.803 and 0.737, respectively. The AUROCs of PAGE-B at each point were continuously higher than those of REACH-B (0.646, 0.725, and 0.653, respectively) and mPAGE-B (0.754, 0.734, and 0.678, respectively).PAGE-B score has a high diagnostic accuracy for HCC development at any time point during NA treatment, indicating its potential use as a real-time monitor of HCC development.

Keywords: Chronic hepatitis B; PAGE-B; hepatocellular carcinoma; nucleotide/nucleoside analog.

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StephenW

接受核苷酸/核苷類似物治療的慢性乙型肝炎患者肝細胞癌預測模型的動態評估
櫻花桐野1，野生伸治1，黑崎昌行1，稻田健太1，山下浩二1，關口平平1，早川由香1，小澤莉娜1，u口麻地1，高田健太郎1，千秋前紀1，順乃金子1，豐井康1，土屋薰1，中西弘之1，板村淳1，高橋優香1，泉浪美1
隸屬關係
聯繫

    1個
    日本東京武藏野紅十字會醫院消化內科和肝病科。

    PMID：33484033 DOI：10.1111 / jvh.13473

抽象

已經提出了慢性乙型肝炎的致癌風險評分，但尚不清楚在核苷/核苷酸類似物（NA）治療期間這些評分是否可用於風險評估。在這項研究中，我們檢查了這些分數的變化以及NA治療期間的可預測性。招募了432名接受過NA治療的無肝細胞癌（HCC）病史的患者。在NA給藥後1年和2年計算PAGE-B，改良的PAGE-B（mPAGE-B）和REACH-B得分。中位隨訪時間為5.1年，其中37例患者（8.6％）發達的HCC。 NA給藥後以及NA給藥後1年和2年，患有PAGE高危患者的HCC累積發生率顯著高於中，低風險組（所有時間點p <0.05），而PAGE中HCC發生率NA給藥後2年發生mPAGE-B和REACH-B高危的患者與中等（p = 0.2）和低危組（p = 0.1）的患者相同。在NA給藥後以及給藥後1年和2年，用於PAGE-B的HCC發生的接受者工作特徵（AUROC）下的面積分別為0.773、0.803和0.737。 PAGE-B的AUROCs連續高於REACH-B（分別為0.646、0.725和0.653）和mPAGE-B（分別為0.74、0.734和0.678）。在NA治療期間的任何時間點，對HCC發生的診斷準確性很高，表明其潛在用途可作為HCC發生的實時監測器。

關鍵字：慢性乙型肝炎； PAGE-B;肝細胞癌；核苷酸/核苷類似物。

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