长期使用普雷尼松可增加自身免疫性肝炎肝硬化中的肝细胞癌风险:一项回顾性队列研究
Jessica Liu1, Rami Hemadeh2,3, Abdelrahman M Attia2,3
1Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
Gastro hep advances
|October 27, 2025
概括
在患有肝硬化的自身免疫性肝炎 (AIH) 患者中,长期使用普得尼松会增加肝细胞癌 (HCC) 的风险. 这项研究发现,在服用较高剂量的普得尼松的患者中,HCC的发病率更高,这表明它是一种独立的风险因素.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 自身免疫性肝炎 (AIH) 是一种免疫媒介的肝脏疾病,导致肝硬化.
- 肝硬化增加肝细胞癌 (HCC) 的风险,可能会被慢性炎症加剧.
- 长期普得尼松治疗对AIH肝硬化患者HCC风险的影响尚不清楚.
研究的目的:
- 调查剂量依赖的普得尼松暴露与AIH和肝硬化患者的HCC发展之间的关联.
- 确定普得尼松是否是该人群中HCC的独立风险因素.
主要方法:
- 对121名成年AIH肝硬化患者的回顾性分析.
- 根据普得尼松暴露 (≥7.5毫克/天≥6个月的肝硬化后诊断) 进行分类的患者.
- 考克斯比例危险模型用于评估HCC发病率和危险比率,根据人口统计和疾病严重程度进行调整.
主要成果:
- 普雷尼松使用与较短的无HCC存活时间有关.
- 在普得尼松组中,HCC发生在25.4%的患者中,而对照组为9.7% (P = .030).
- 多变量分析证实了普得尼松是HCC的一个独立风险因素 (调整后的危险比:3.36;P = .040).
结论:
- 长时间暴露于普得尼松是AIH肝硬化患者中HCC发展的独立风险因素.
- 机制性途径可能涉及普得尼松的免疫抑制和代谢作用,影响免疫监测和促进纤维化/瘤发生.
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