在慢性乙型肝炎患有低水平病毒性病的患者中,肝细胞癌发展的风险因素和诺莫格拉姆模型
Yu-Ching Chen1,2, Chun-Chi Yang1, Hsing-Tao Kuo1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Yongkang District, Tainan, Taiwan.
International journal of medical sciences
|July 15, 2024
概括
患有慢性乙型肝炎 (CHB) 和低水平病毒病 (LLV) 的患者面临着持续的肝细胞癌 (HCC) 风险. 一种新的名录模型有助于预测LLV的CHB患者的HCC风险,有助于治疗决策.
科学领域:
- 肝病学和病毒性肝炎研究研究
- 瘤学和癌症风险预测预测
- 临床流行病学和队列研究.
背景情况:
- 慢性乙型肝炎 (CHB) 患有低水平病毒病 (LLV) 的患者并非没有肝细胞癌 (HCC) 的风险.
- 对于患有LLV的CHB患者,最佳的抗病毒治疗策略仍在争论中.
- 准确的风险分层对于管理LLV的CHB患者至关重要.
研究的目的:
- 调查LLV.CHB患者中HCC发展的风险.
- 为了确定LLV.CHB患者中HCC的独立风险因素.
- 开发和验证一个用于预测该人群中HCC风险的诺莫格拉姆模型.
主要方法:
- 对16895名CHB患者的回顾性队列研究 (2008年1月 - 2020年12月).
- 在三个组中对HCC发病率进行比较:LLV,维护病毒学反应 (MVR) 和HBV-DNA>2000 IU/mL.
- 考克斯回归分析用于风险因素识别和名录构造;10倍交叉验证用于内部验证.
主要成果:
- 在平均5.78年的随访期间,发生了408例新的HCC病例.
- 在LLV组3,5年和10年的累计HCC风险分别为3.56%,4.96%和9.51%.
- 在LLV组中,独立的HCC风险因素包括男性性别,年龄,肝硬化和血小板数;3年和5年预测的AUC分别为0.75和0.76.
结论:
- 患有LLV和MVR的CHB患者仍然存在患HCC的显著风险.
- 开发的诺米图有效地预测了LLV的CHB患者的HCC无结果.
- 这个名图为优化监测和抗病毒治疗决策提供了有价值的数据.
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