他汀类药物的使用与乙型肝炎病毒相关肝细胞癌患者更好的

StephenW

欧洲临床投资杂志

. 2022 年 12 月 11 日；e13936。
内政部：10.1111/eci.13936。 先于印刷在线。
他汀类药物的使用与乙型肝炎病毒相关肝细胞癌患者更好的术后预后相关
Byungyoon Yun 1，Sang Hoon Ahn 2 3 4，Juyeon Oh 5，Jin-Ha Yoon #1 6，Beom Kyung Kim #2 3 4
隶属关系
隶属关系

     1个
     韩国首尔延世大学医学院预防医学系。
     2个
     韩国首尔延世大学医学院内科。
     3个
     延世大学医学院胃肠病学研究所，首尔，大韩民国。
     4个
     大韩民国首尔延世大学卫生系统 Severance 医院延世肝脏中心。
     5个
     大韩民国首尔延世大学医学院研究生院公共卫生系。
     6个
     韩国首尔延世大学医学院职业健康研究所。

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贡献相等。

     PMID：36504405 DOI：10.1111/eci.13936

抽象的

背景：肝细胞癌 (HCC) 的高术后复发率是一个重大挑战。 患者代谢因素是潜在的疾病修饰因素，应作为术后预后的危险因素进行检查。 在这里，我们评估了长期使用他汀类药物与乙型肝炎病毒 (HBV) 相关 HCC 手术切除后 HCC 复发之间的关联。

方法：招募了在 2005 年至 2015 年间最初接受 HBV 相关 HCC 根治性切除术的患者并随访至 2019 年 12 月。根据患者是否服用他汀类药物 ≥ 2年。 主要结果是 HCC 复发，次要结果是肝脏相关死亡率。 使用 Kaplan-Meier 方法估计他汀类药物使用的累积发生率，并使用对数秩检验进行比较。 使用多变量 Cox 回归估计调整后的风险比 (HR) 和 95% 置信区间 (CI)。

结果：在中位随访 6.1 年的 5,653 名患者中，分别有 1,603 名和 316 名患者发生 HCC 复发和肝脏相关死亡率。 他汀类药物使用者组 HCC 复发的 5 年累积发生率 (15.9%) 显着低于非使用者组 (21.3%；p = 0.019)。 根据多变量 Cox 回归分析，他汀类药物的使用与降低 HCC 复发风险（aHR 0.77，95% CI：0.61-0.98；p=0.035）和肝脏相关死亡率（aHR 0.48，95% CI：0.25-0.90）显着相关 ；p=0.023）。

结论：长期使用他汀类药物与 HBV 相关 HCC 根治性切除术后 HCC 复发风险和肝脏相关死亡率的降低显着相关。

关键词：肝细胞癌； 他汀类药物; 慢性乙型肝炎； 预后； 复发； 手术切除。

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StephenW

Eur J Clin Invest

. 2022 Dec 11;e13936.
doi: 10.1111/eci.13936. Online ahead of print.
Statin Use is Associated with Better Post-Operative Prognosis Among Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma
Byungyoon Yun  1 , Sang Hoon Ahn  2   3   4 , Juyeon Oh  5 , Jin-Ha Yoon #  1   6 , Beom Kyung Kim #  2   3   4
Affiliations
Affiliations

    1
    Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
    2
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
    3
    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
    4
    Yonsei Liver Centre, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
    5
    Department of Public Health, Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
    6
    The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.

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Contributed equally.

    PMID: 36504405 DOI: 10.1111/eci.13936

Abstract

Background: The high postoperative recurrence rate of hepatocellular carcinoma (HCC) is a significant challenge. Patient metabolic factors are potential disease modifiers and should be examined as risk factors for postoperative prognosis. Here, we assessed the association between long-term statin use and HCC recurrence after surgical resection of hepatitis B virus (HBV)-related HCC.

Methods: Patients who initially underwent curative resection for HBV-related HCC between 2005 and 2015 were recruited and followed up until December 2019. Patients were classified into statin user and non-statin user groups based on whether or not they had been prescribed statins for ≥2 years. The primary outcome was HCC recurrence, and the secondary outcome was liver-related mortality. The cumulative incidence by statin use was estimated using the Kaplan-Meier method and compared using the log-rank test. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression.

Results: Among 5,653 patients with a median 6.1 years of follow-up, HCC recurrence and liver-related mortality occurred in 1,603 and 316 patients, respectively. The 5-year cumulative incidence of HCC recurrence in the statin user group (15.9%) was significantly lower than that in the non-user group (21.3%; p = 0.019). From multivariable Cox regression analysis, statin use was significantly associated with a reduced risk of HCC recurrence (aHR 0.77, 95% CI: 0.61-0.98; p=0.035) and liver-related mortality (aHR 0.48, 95% CI: 0.25-0.90; p=0.023).

Conclusion: Long-term statin use was significantly associated with reduced risk of HCC recurrence and liver-related mortality after curative resection of HBV-related HCC.

Keywords: HCC; Statin; chronic hepatitis B; prognosis; recurrence; surgical resection.

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