与酒精相关的肝硬化症患者的酒精使用和肝细胞癌风险
Frederik Kraglund1, Rasmine Birn-Rydder1, Mia Dahl Sørensen2
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Scandinavian journal of gastroenterology
|June 8, 2023
概括
在酒精相关肝硬化患者中,持续危险的酒精使用与较高的死亡率和降低肝细胞癌 (HCC) 风险有关. 在禁酒的患者中,HCC监测可能更有效.
科学领域:
- 肝病学和胃肠道学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 对与酒精有关的肝硬化 (ALD肝硬化) 患者来说,肝细胞癌 (HCC) 监测至关重要.
- 了解风险因素,包括持续饮酒,对于优化监测策略至关重要.
研究的目的:
- 调查持续危险饮酒对ALD肝硬化患者HCC风险的影响.
- 为了在ALD肝硬化队伍中比较危险酒精使用者和匹配的非使用者之间的HCC风险和全因死亡率.
主要方法:
- 一项基于全国注册的队列研究使用细灰和考克斯回归比较了HCC风险和死亡率.
- 一项临床病例控制研究分析了与使用危险酒精相关的HCC风险,该风险由AUDIT-C量化.
- 使用后勤回归来评估危险饮酒与HCC风险之间的关联.
主要成果:
- 在注册研究中 (8,616名使用者与8,616名非使用者),持续使用危险酒精显示HCC风险较低 (SHR:0.64),但死亡率较高 (HR:1.62).
- 临床研究 (146名患者) 发现危险的酒精使用与较低的HCC风险无关 (OR:0.61).
结论:
- 在ALD肝硬化中,危险的酒精使用与死亡率的增加有关,这矛盾地降低了观察到的HCC风险.
- 在不涉及危险酒精使用的ALD肝硬化患者中,HCC监测策略可能会产生更好的结果.
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