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发表于 2003-12-10 09:26
2003年03月31日
38th Annual Meeting of the EASL
Persistently Positive HBeAg Is Independent Risk Factor for Hepatocellular Carcinoma
Abstract Summary
Results of previous population-based studies in Taiwan and Alaska suggest positive HBeAg as a risk factor for hepatocellular carcinoma (HCC), but the status of liver cirrhosis among the studied patients was not defined. Researchers at the Department of Medicine at the Chinese University of Hong Kong investigated whether positive HBeAg is an independent risk factor for HCC.
Patients with chronic hepatitis B were prospectively followed up 6-monthly with monitoring of HBeAg status and alfa-fetoprotein levels. HCC was confirmed imaging and/or histology. Liver cirrhosis was defined as ultrasonic cirrhosis plus hypersplenism, ascites and/or varices. A Cox-proportional hazard model was used to estimate the relative risk of HCC development in relationship with age, gender, liver cirrhosis and HBeAg profile.
427 patients (279 male and 148 female) were followed up for a median of 44 months (range 3 to 55). Twenty-one patients developed HCC after follow up for a median of 18) months (range 3 to 43).
The adjusted relative risk (ARR) of HCC was significantly higher among patients who had persistently positive HBeAg (n=89) as compared to patients with persistently negative HBeAg (n=257) (2.80, 95% CI 1.02-7.63).
Fluctuating HBeAg status (n=36) did not associate with increased risk of HCC (ARR 1.6, 95% CI 0.43-5.53). None of the patients who underwent sustained HBeAg seroconversion developed HCC (n=45). Cirrhosis was associated with a high risk of HCC (ARR 7.24, 95% CI 2.91-18.01).
Conclusion
Persistently positive HBeAg in the absence of cirrhosis is an independent risk factor for hepatocarcinogenesis and close surveillance should be offered.
Reference
HLY Chan and others. PERSISTENTLY POSITIVE HEPATITIS B E ANTIGEN ISASSOCIATED WITH INCREASED RISK OF HEPATOCELLULAR CARCINOMA. Abstract 3020.00. Abstracts of the 38th Annual Meeting of the European Association of the Study of the Liver (EASL).
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