在ELF得分的动态变化预测肝细胞癌在慢性乙型肝炎患者接受抗病毒治疗
Lilian Yan Liang1,2, Terry Cheuk-Fung Yip1,2, Jimmy Che-To Lai1,2
1Medical Data Analytics Centre (MDAC), The Chinese University of Hong Kong, Hong Kong SAR, China.
Journal of viral hepatitis
|September 10, 2024
概括
经过三年的增强性肝纤维化 (ELF) 评分的变化有助于预测慢性乙型肝炎 (CHB) 患者的肝细胞癌 (HCC) 风险. 动态ELF得分变化,结合LSM-HCC得分,改善HCC风险分层.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 病毒学 病毒学
背景情况:
- 增强性肝纤维化 (ELF) 评分是肝纤维化的非侵入性生物标志物.
- 肝细胞癌 (HCC) 是慢性乙型肝炎 (CHB) 患者的主要并发症.
- 目前的CHB患者中HCC的风险分层模型需要改进.
研究的目的:
- 评估三年ELF得分变化对CHB患者中HCC发展的预测性能.
- 评估动态ELF得分变化和肝硬度测量 (LSM) -HCC得分在分层化HCC风险中的联合实用性.
- 调查ELF得分变化显示的纤维化进展或回归与HCC发病率之间的关联.
主要方法:
- 一项前性队列研究,涉及445名CHB患者.
- 患者接受了两次过渡性弹性图 (TE) 检查和ELF评分评估,大约三年间隔.
- 使用LSM-HCC得分来定义基线中等和高HCC风险.
主要成果:
- 在中等和高风险组中,ELF得分的变化显著分层化了HCC风险 (分别p < 0.001和p = 0.011).
- 持续轻度/中度纤维化患者的HCC风险最低 (4.0%).
- 患有纤维化回归 (11.3%) 或进展/持续严重纤维化 (>20%) 的患者在平均163个月的随访期间显著增加了HCC风险.
结论:
- 在ELF得分的动态变化为CHB患者的HCC发展提供了有价值的预后信息.
- 将ELF得分变化与LSM-HCC得分相结合,可以提高HCC风险分层的准确性.
- 使用ELF评分监测纤维化进展或回归,可以帮助个人化CHB患者的HCC监测策略.
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