在不确定阶段的慢性乙型肝炎患者中,肝细胞癌
Lung-Yi Mak1, Leland J Yee2, Robert J Wong3,4
1Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Special Administrative Region, China.
Journal of viral hepatitis
|May 8, 2024
概括
在未确定阶段的乙型肝炎病毒 (HBV) 患者面临肝细胞癌 (HCC) 的风险增加. 抗病毒疗法可以减轻这种风险,因此需要进一步考虑治疗策略.
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:
- 乙型肝炎病毒 (HBV) 感染的进展经历了明确的阶段,但有些患者进入"不确定的阶段",缺乏明确的分类.
- 这个不确定的阶段,可能会影响高达50%的HBV患者,其特点是含糊不清的生物标志物水平.
- 这个阶段的定义在指导方针中因生物标志物的截止值不同而有所不同.
研究的目的:
- 审查HBV感染未确定阶段患者的关键数据.
- 强调不确定阶段与肝细胞癌 (HCC) 风险增加之间的关联.
- 检查抗病毒疗法在降低HCC风险方面的潜在作用,在这个患者群体.
主要方法:
- 对临床数据的审查,将未确定阶段患者与增加的HCC风险联系起来.
- 对分子证据的分析,包括HBV-DNA集成和免疫激活.
- 整体方法整合了生物数据,临床观察和治疗结果.
主要成果:
- 在未确定阶段的患者表现出肝癌发生的分子证据,尽管肝酶正常.
- 在这个群体中观察到HBV-DNA融入宿主基因组和免疫激活.
- 抗病毒治疗已经证明可以减少纤维化和HCC风险.
结论:
- 乙型肝炎病毒感染的不确定的阶段存在重大风险,特别是在HCC发展方面.
- 抗病毒疗法提供了一种策略,通过向潜在机制来减轻这些风险.
- 进一步考虑抗病毒治疗对于管理未确定阶段患者的残留HCC风险至关重要.
相关概念视频
01:25Hepatitis
86
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
86
01:23Cirrhosis I: Introduction
28
Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
28
01:24Cirrhosis II: Pathophysiology
42
Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to...
42