在治疗期间,与HBV肝硬化患者不同的脱补偿事件相关的明显的HCC风险
Yuanyuan Kong1,2, Yameng Sun3, Xiaoning Wu3
1Clinical Epidemiology & EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Hepatology international
|August 19, 2023
概括
慢性乙型肝炎 (CHB) 患有补偿性肝硬化 (CC) 患者的核酸类比 (NA) 治疗显示,肝细胞癌 (HCC) 的风险高于去补偿. 特定的去补偿事件显著影响后续发展HCC的风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 在瘤学瘤学.
背景情况:
- 众所周知,长期的核类比 (NA) 治疗可以降低补偿性肝硬化症 (CCC) 和肝细胞癌 (HCC) 的风险,在患有补偿性肝硬化症 (CC) 的慢性乙型肝炎 (CHB) 患者中.
- 然而,抗病毒治疗对脱补偿与HCC的特定风险的影响差异需要进一步阐明.
- 了解疾病状态过渡对于优化CHB患者的治疗策略至关重要.
研究的目的:
- 为了研究与CC的NA治疗的CHB患者的疾病状态过渡.
- 具体分析不同脱补偿事件后HCC发展的风险.
- 提供关于该患者群体中HCC风险分层的见解.
主要方法:
- 预期对1163名接受NA治疗的CHB患者进行长达7年的随访.
- 卡普兰-梅尔分析和竞争风险模型来评估HCC的累积发病率和风险.
- 多状态模型用于估计来自不同疾病状态的HCC过渡概率.
主要成果:
- 肝细胞癌 (HCC) 是主要的肝脏相关事件,其5年累计发病率为9.0%.
- 脱补偿发生在5年累计发病率为8.3%,非出血性脱补偿比水出血更频繁.
- 脱补偿阶段显示,与补偿性肝硬化 (CC) 阶段 (9.1%) 相比,5年累计HCC发病率 (27.6%) 显著更高. 非出血性失补偿事件显示,过渡到HCC的概率高于出血事件.
- 病毒抑制与治疗期间过渡到HCC的风险降低有关.
结论:
- 在接受NA治疗的CHB患者中,HCC发展的风险高于不补偿的风险.
- 不同类型的脱补偿事件给后续的HCC发展带来了不同的风险.
- 这些发现强调了监测HCC的重要性,特别是在特定的脱补偿事件后,在NA治疗的CCCHB患者中,特别是在接受NA治疗的CC患者中.
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