在肝细胞癌诊断之前,B型肝炎病毒抗病毒治疗率的变化:韩国全国性研究
Young Eun Chon1, Jonghyun Lee2, Eileen L Yoon3
1Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam.
European journal of gastroenterology & hepatology
|September 2, 2025
概括
在乙型肝炎病毒相关的肝癌诊断之前的抗病毒治疗显著改善了韩国的生存率. 然而,老年患者的吸收率仍然很低,因此需要有针对性的干预措施以获得更好的结果.
科学领域:
- 肝病学
- 癌症学
- 公共卫生
背景情况:
- 抗病毒治疗 (AVT) 对于治疗乙型肝炎病毒 (HBV) 感染至关重要,可降低HBV再激活和肝细胞癌 (HCC) 风险.
- 相对于HCC诊断,AVT的最佳时间及其对患者预后的影响需要进一步调查.
研究的目的:
- 评估在韩国HCC诊断之前开始的AVT的趋势和临床结果.
- 根据患者人口统计和治疗方式来确定AVT吸收的差异.
主要方法:
- 韩国全国医疗保险服务数据库的分析 (2008-2018).
- 将患者分为早期 (2008 - 2013) 和晚期 (2014 - 2018) 队列进行趋势分析.
- 关联点回归用于AVT趋势分析和对象之间的临床结果比较.
主要成果:
- 在HCC诊断之前接受AVT的患者比例在2008年至2018年间从22. 4%增加到46. 8%.
- 与早期队列相比,晚期队列的整体生存率显著提高 (P < 0. 001).
- 在HCC诊断之前的AVT与40. 8%的死亡率降低有关 (aHR=0. 592; P < 0. 001),特别是在接受移植或切除的患者中.
结论:
- 在韩国在HCC诊断之前的AVT率在过去十年中显著增加.
- 在HCC诊断之前启动AVT可以改善HBV相关HCC患者的生存结果.
- 需要有针对性的策略来增加老年患者 (≥80岁) 的AVT吸收率.
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