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在C型肝炎患者直接作用抗病毒药物后血清α胎儿蛋白正常化降低肝细胞癌风险

Cheng-Kuan Lin¹, Ssu-Han Wang², Tzong-Hsi Lee²

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Nanya South Road, Section 2, Banqiao District, New Taipei City, 220216, Taiwan. widelin@mail.femh.org.tw.

Scientific reports

|September 2, 2025

概括

在慢性型肝炎 (CHC) 抗病毒治疗后,阿尔法胎蛋白 (AFP) 水平正常化显著降低了患肝癌 (HCC) 的风险. 稳定的正常AFP水平也表明CHC患者的HCC风险较低.

科学领域:

肝病学
癌症学
病毒学

背景情况:

血清α-胎蛋白 (AFP) 的升高在慢性型肝炎 (CHC) 患者中很常见.
在抗病毒治疗后,AFP水平通常会下降.
在没有基线HCC的CHC患者中,治疗后AFP正常化的预后值需要进一步调查.

研究的目的:

研究治疗后AFP正常化与CHC患者中HCC发展风险之间的关联.
用直接作用抗病毒药物 (DAA) 治疗的CHC患者的HCC风险因素.

主要方法:

分析了一组483名CHC患者,他们接受了基于索福斯布维尔的DAA治疗.
对患者进行了平均38. 8个月的随访.
统计分析确定了HCC的独立风险因素,包括年龄,肝硬化和治疗后的AFP水平.

主要成果:

持续病毒学反应 (SVR) 率高达98. 6%.
在治疗后,86. 2% 的患者达到了AFP正常化 (12周AFP水平< 7 ng/ ml).
在5. 4%的患者中发生HCC;独立的风险因素包括65岁以上,肝硬化和治疗后AFP> 7ng/ ml.
与持续升高AFP患者相比,治疗后AFP水平正常或稳定,HCC风险比率显著降低.

结论:

在DAA治疗后,正常化或稳定的正常AFP水平与CHC患者的HCC风险显著降低有关.
治疗后的AFP水平作为预测CHC患者HCC风险的有价值生物标志物.
这一发现支持基于抗病毒治疗后的AFP水平的持续监测和风险分层.

关键词:

阿尔法胎蛋白慢性肝炎c 直接作用的抗病毒药物肝细胞癌规范化危险性

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