肝细胞癌病因驱动生存结果:基于人口的分析
Hannah M Cranford1, Patricia D Jones2,3, Robert J Wong4,5
1Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.
概括
与酒精有关的肝病 (ALD) 显著恶化肝细胞癌 (HCC) 患者的生存率,特别是那些具有双重病因的人. 改善查和治疗对于具有多个HCC风险因素的个体至关重要.
科学领域:
- 肝病学和瘤学研究.
- 公共卫生和流行病学.
- 癌症生存率分析.
背景情况:
- 以前的肝细胞癌 (HCC) 存活率研究受到队列限制和广泛的病因类别的限制.
- 这项研究检查了基于人口的HCC存活率在七个不同的病因组,包括病毒性,与酒精有关的和非酒精性脂肪肝病,考虑双重病因.
- 临床和社会人口统计学因素被纳入分析.
研究的目的:
- 根据七个不同的病因类别 (包括独立和双重病因) 调查肝细胞癌 (HCC) 的生存率.
- 为了确定与较差的生存结果相关的特定HCC病因.
- 为公共卫生策略和HCC治疗点的识别提供信息.
主要方法:
- 利用佛罗里达州癌症登记处的2005年至2018年间诊断的HCC病例数据.
- 将注册表数据与出院和病毒性肝炎信息联系起来,以确定HCC病因学.
- 对15616例HCC病例进行了因果特异性生存分析,包括考克斯回归.
主要成果:
- 仅型肝炎病毒 (HCV) 是最常见的病因 (31.9%),其次是HCV与酒精相关的肝病 (ALD) 双重病因 (16.3%).
- 对HCC的整体五年调整后生存率低至17.6%.
- 与ALD相关的HCC病因 (仅ALD,HCV-ALD,HBV-ALD) 与非ALD原因相比显示出明显较低的存活率. ALD和HBV-ALD HCC显示死亡风险较高 (分别为1.20和1.28倍),而不是只有HCV的HCC.
结论:
- 肝细胞癌 (HCC) 与与酒精有关的肝病 (ALD) 作为唯一或贡献的病因与预后比单独的病毒病因更糟糕.
- 对于患有多种HCC风险因素的患者,有必要加强查和针对性治疗策略.
- 了解HCC存活率的病因差异对于开发有针对性的生物标志物,疗法和公共卫生干预措施至关重要.
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