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J Hepatol:持续病毒学应答对肝癌风险的影响

2016-11-10 MedSci MedSci原创

我们对加拿大的一个大型以人口为基础的队列进行了研究,评估持续病毒学应答(SVR)对HCC风险和SVR后HCC发生率的影响。 BC-HTC队列包括了个体1990–2013年期间的HCV检测,以及个体的医疗数据、住院情况、癌症、处方药和死亡率等情况。对接受干扰素为基础的HCV患者进行随访,时间为从停止治疗开始,到诊断HCC、死亡或2012年12月31日。 对8147例接受HCV治疗的个体进

我们对加拿大的一个大型以人口为基础的队列进行了研究,评估持续病毒学应答(SVR)对HCC风险和SVR后HCC发生率的影响。

BC-HTC队列包括了个体1990–2013年期间的HCV检测,以及个体的医疗数据、住院情况、癌症、处方药和死亡率等情况。对接受干扰素为基础的HCV患者进行随访,时间为从停止治疗开始,到诊断HCC、死亡或2012年12月31日。

对8147例接受HCV治疗的个体进行分析,达到SVR和未达到SVR的人数分别为4663(57%)和3484(43%)。每一组中位随访时间为5.6年[范围: 0.5-12.9]。达到SVR和未达到SVR组的肝癌发生率分别为1.1/1000人年和7.2/1000人年。肝硬化患者的肝癌发病率更高(SVR: 6.4, no-SVR: 21.0/1000 PY)。

在多变量模型中,SVR与较低的肝癌风险相关(SHR=0.20, 95%CI: 0.13-0.3),但是肝硬化(SHR=2.61, 95%CI:1.68-4.04)、年龄≥50岁、男性、感染基因3型与较高的HCC风险相关。达到SVR的患者中,肝硬化、年龄≥50岁、男性与较高的HCC风险相关。

干扰素治疗后达到SVR,虽然可以大大降低肝癌风险,但不能消除肝癌风险。肝硬化和年龄≥50岁者的肝癌风险更高。

原始出处:

Naveed Z. Janjua, Mel Krajden, Mark Tyndall,Long-term effect of sustained virological response on hepatocellular carcinoma in patients with hepatitis C in Canada.J Hepatol.DOI: http://dx.doi.org/10.1016/j.jhep.2016.10.028

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    2017-03-28 sjq027
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    2016-11-12 gwc384
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    2016-11-12 周虎

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