HBV DNA水平低的患者抗病毒治疗对肝细胞癌经动脉化疗栓塞的

StephenW

Effect of antiviral therapy in patients with low HBV DNA level on transarterial chemoembolization for hepatocellular carcinoma
Myung Pyo Kim  1 , Jae Kook Yang  2 , Baek Gyu Jun  1 , Young Don Kim  1 , Gab Jin Cheon  1 , Hee Jae Jung  3 , Jeong-Ju Yoo  3 , Sang Gyune Kim  3 , Young Seok Kim  3 , Soung Won Jeong  4 , Jae Young Jang  4 , Hong Soo Kim  2 , Sae Hwan Lee  2
Affiliations
Affiliations

    1
    Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea.
    2
    Department of Internal Medicine, Soonchunhyang University College of Medicine Cheonan Hospital, Cheonan, South Korea.
    3
    Department of Internal Medicine, Soonchunhyang University College of Medicine Bucheon Hospital, Bucheon, South Korea.
    4
    Department of Internal Medicine, Soonchunhyang University College of Medicine Seoul Hospital, Seoul, South Korea.

    PMID: 33759295 DOI: 10.1111/jvh.13508

Abstract

Antiviral therapy improves survival in patients with hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC). However, the effect of antiviral therapy in patients with low-level viremia HBV-HCC receiving non-curative therapy remains unclear. We aimed to evaluate the role of antiviral therapy in patients with low-level viremia and treated with transarterial chemoembolization (TACE). This retrospective study evaluated 206 patients with HBV-HCC who underwent TACE as an initial treatment. Of those, 135 patients received antiviral therapy (antiviral group), and 71 did not (non-antiviral group). The definition of low-level viremia was an HBV DNA level <2,000 IU/mL. Kaplan-Meier curves, log-rank tests, and Cox regression analysis were used for statistical analyses. The median follow-up duration was 39 months (1-174 months). Overall survival (OS) did not differ between groups (P = 0.227). Barcelona Clinic Liver Cancer stage (BCLC), Child-Pugh (CP) class, and α-fetoprotein level were independent prognostic factors for OS. Antiviral therapy (hazard ratio [HR], 0.503, P = 0.022) was a prognostic factor for 2-year survival. On subgroup analysis, antiviral therapy improved short-term survival in patients with BCLC stage 0 and A (P = 0.037) and CP class A (P = 0.04). In patients with low-level viremia, antiviral therapy yielded short-term survival benefits, particularly in patients with early-stage HCC.

Keywords: Hepatocellular carcinoma; antiviral therapy; chemoembolization; hepatitis B virus; survival.

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StephenW

HBV DNA水平低的患者抗病毒治疗对肝细胞癌经动脉化疗栓塞的影响
金明P 1，Jae Kook Yang 2，白G俊1，Young Don Kim 1，Gab Jin Cheon 1，Hee Jae Jung 3，郑正汝3，Sang Gyune Kim 3，Young Seok Kim 3，Soung Won Jeong 4 ，李在长4，洪秀金2，西焕李2
隶属关系
隶属关系

    1个
    蔚山医学院大学内科，韩国江陵市江陵市牙山医院。
    2个
    淳春市大学医学院内科，天安医院，韩国天安市。
    3
    朝鲜春川大学医学院附属富川医院内科。
    4
    淳春市大学医学院首尔医院内科，韩国首尔。

    PMID：33759295 DOI：10.1111 / jvh.13508

抽象的

抗病毒治疗可改善乙型肝炎病毒（HBV）诱导的肝细胞癌（HCC）患者的生存率。但是，对于接受非治疗的低水平病毒血症HBV-HCC患者，抗病毒治疗的效果尚不清楚。我们旨在评估抗病毒治疗在低水平病毒血症和经动脉化学栓塞（TACE）治疗的患者中的作用。这项回顾性研究评估了206例接受TACE初始治疗的HBV-HCC患者。其中，135例接受抗病毒治疗（抗病毒组），71例未接受抗病毒治疗（非抗病毒组）。低水平病毒血症的定义是HBV DNA水平<2,000 IU / mL。使用Kaplan-Meier曲线，对数秩检验和Cox回归分析进行统计分析。中位随访时间为39个月（1-174个月）。两组之间的总生存期（OS）没有差异（P = 0.227）。巴塞罗那临床肝癌分期（BCLC），Child-Pugh（CP）级和甲胎蛋白水平是OS的独立预后因素。抗病毒治疗（危险比[HR]为0.503，P = 0.022）是2年生存的预后因素。在亚组分析中，抗病毒治疗改善了BCLC 0级和A级（P = 0.037）和CP A级（P = 0.04）的患者的短期存活率。在低水平病毒血症患者中，抗病毒治疗可带来短期生存获益，尤其是在早期HCC患者中。

关键词：肝细胞癌；抗病毒治疗；化学栓塞乙型肝炎病毒;生存。

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