在灰色区域的肝炎患者肝细胞癌的概率分析
Jianna Zhang1, Sijie Yu2, Kailu Zhu3
1Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Frontiers in medicine
|January 8, 2025
概括
在灰色区域 (GZ) 慢性乙型肝炎 (CHB) 患者患肝细胞癌 (HCC) 的风险更高. 建议早期使用抗乙型肝炎病毒治疗,特别是在GZ-B亚组.
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:
- 慢性乙型肝炎 (CHB) 构成肝细胞癌 (HCC) 的重大风险.
- 灰色区域 (GZ) 患者代表了CHB管理中的中间类别,具有不确定的HCC风险.
- 了解GZ患者的HCC概率对于临床实践至关重要.
研究的目的:
- 调查一大群患有CHB的GZ患者中发展HCC的概率.
- 根据HBeAg,ALT和HBV的DNA水平,将GZ患者分为分组.
- 将GZ患者的HCC风险与其他CHB临床组进行比较.
主要方法:
- 对2013年1月至2023年1月期间诊断和治疗的CHB患者的回顾性分析.
- 根据特定的生物标志物将GZ患者分为四类 (GZ-A,GZ-B,GZ-C,GZ-D).
- 治疗权重的逆概率 (IPTW) 调整用于比较分析.
主要成果:
- 整体GZ组在IPTW调整后,与免疫耐受性,HBeAg阳性免疫活性和非活性CHB组相比,HCC发展的概率相似.
- GZ-B亚组 (HBeAg阳性,ALT>ULN,HBV DNA ≤2×104 IU/ml) 的HCC概率与免疫活性和HBeAg阴性免疫活性组相似.
- 经IPTW调整后的分析表明,GZ组,特别是GZ-B子组的HCC风险较高.
结论:
- GZ集团,特别是GZ-B子集团,呈现出高瘤癌的高风险.
- 对于GZ患者,特别是GZ-B亚组患者,早期考虑抗乙肝B病毒治疗是有必要的.
- 这项研究强调了风险分层和及时干预在灰色区域内管理CHB患者的重要性.
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