Incidence of hepatocellular carcinoma in chronic hepatitis B patients

StephenW

J Hepatol. 2010 Apr 27. [Epub ahead of print]

Incidence of hepatocellular carcinoma in chronic hepatitis B patients
receiving nucleos(t)ide therapy: A systematic review.

Papatheodoridis GV, Lampertico P, Manolakopoulos S, Lok A.
2nd Department of Internal Medicine, Athens University Medical School, Athens,
Greece.

Abstract
Background & Aims: Chronic hepatitis B patients are at increased risk for
hepatocellular carcinoma (HCC). The effect of medium-term nucleos(t)ide
analogue therapy on HCC incidence is unclear; therefore, we systematically
reviewed all the data on HCC incidence from studies in chronic hepatitis B
patients treated with nucleos(t)ide analogues. Methods: We performed a
literature search to identify studies with chronic hepatitis B patients
treated with nucleos(t)ide analogues for 24months. Results: Twenty-one studies
including 3881 treated and 534 untreated patients met our inclusion criteria.
HCC was diagnosed in 2.8% and 6.4% of treated and untreated patients,
respectively, during a 46 (32-108) month period (p=0.003), in 10.8% and 0.5%
of nucleos(t)ide naive patients with and without cirrhosis (p<0.001) and in
17.6% and 0% of lamivudine resistance patients with and without cirrhosis
(p<0.001). HCC developed less frequently in nucleos(t)ide naive patients
compared to those without virological remission (2.3% vs 7.5%, p<0.001), but
there was no difference between lamivudine resistance patients with or without
virological response to rescue therapy (5.9% vs 8.8%, p=0.466). Conclusions:
Chronic hepatitis B patients receiving medium-term nucleos(t)ide analogue
therapy had a significantly lower incidence of HCC compared to untreated
patients but treatment does not completely eliminate the risk of HCC. Among
the treated patients, cirrhosis, HBeAg negative at baseline and failure to
remain in virological remission were associated with an increased risk of HCC.
Copyright © 2010 European Association for the Study of the Liver. Published
by Elsevier B.V. All rights reserved.

PMID: 20483498 [PubMed - as supplied by publisher]

guixiaogang

　肝癌的发病率在慢性乙型肝炎患者
　　4月27日的相关性研究[J].。到2010年出版前Epub。)
　　
　　肝癌的发病率在慢性乙型肝炎患者
　　接收nucleos(t):一种系统化综述ide治疗。
　　
　　Papatheodoridis GV Lampertico P,Manolakopoulos,是洛克。
　　第二部的内科医生,雅典大学医学院,雅典,
　　希腊。
　　
　　摘要
　　背景和目的:慢性乙型肝炎病人的风险增加
　　肝细胞癌(HCC)。中期nucleos效果的ide(t)
　　模拟治疗肝癌的发病率仍不明,因此,我们进行了系统的分析
　　回顾所有的数据,从研究肝癌的发病率在慢性乙型肝炎
　　治疗的患者中,使用核苷类似物。方法:我们进行了一项
　　研究文献检索鉴定与慢性乙型肝炎
　　治疗使用核苷类似物对24months。结果:21岁的研究
　　未经治疗,包括3881病人向符合我们的选择标准。
　　肝癌的诊断和治疗的6.4% 2.8%,未经处理的病人,
　　在一个46(分别为32-108)月期(p = 0.003),在解析和0.5%
　　nucleos(t)的ide天真与非肝硬化患者(p < 0.001)
　　对拉米夫定耐药和0% 17.6%和无肝硬化患者
　　(p < 0.001)。肝癌经常在nucleos发达少(t)的ide天真的病人
　　相比,那些没有发生病毒突变缓解(2.3% vs 7.5%,差异有显著性(p < 0.001),但
　　没有区别拉米夫定耐药的病人有或没有
　　病毒应答抢救治疗(5.9% vs 8.8%,p = 0.466)。结论:
　　慢性乙型肝炎病人接受中期nucleos(t)的ide模拟
　　治疗肝癌的发病率明显低于对照相比
　　治疗病人,但并没有完全消除风险的肝细胞癌。在
　　在接受治疗的患者,肝硬化,HBeAg消极的基线和失败
　　保持在其中缓解与肝癌的发病风险增高。
　　版权©2010年欧洲肝脏。出版
　　由出版社。版权所有。
　　
　　PMID:20483498[公共医学-提供出版商]