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肝胆相照论坛 论坛 肝癌,肝移植 HBV DNA水平低的患者抗病毒治疗对肝细胞癌经动脉化疗栓 ...
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[其他] 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 [复制链接]

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发表于 2021-3-26 21:01 |只看该作者 |倒序浏览 |打印
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.

This article is protected by copyright. All rights reserved.

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30437 
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发表于 2021-3-26 21:01 |只看该作者
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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