乙型肝炎病毒RNA预测肝细胞癌尽管病毒抑制
Takashi Kumada1,2, Hidenori Toyoda3, Satoshi Yasuda3
1Department of Nursing, Faculty of Nursing, Gifu Kyoritsu University, Gifu, Japan.
Alimentary pharmacology & therapeutics
|December 2, 2025
概括
乙型肝炎病毒 (HBV) 的RNA水平,而不是HBcrAg,预测了核酸类比治疗中慢性乙型肝炎 (CHB) 患者的肝细胞癌 (HCC) 风险. 可量化的HBVRNA表明HCC的发育率更高.
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) 患者接受核酸类比 (NA) 治疗仍有肝细胞癌 (HCC) 的风险,即使具有无法检测的乙型肝炎病毒 (HBV) DNA.
- 需要新的生物标志物来改善接受NA治疗的CHB患者的HCC风险分层.
研究的目的:
- 评估血清HBVRNA和乙型肝炎核心相关抗原 (HBcrAg) 水平之间的关联以及随后的HCC发展.
- 在CHB患者中评估这些生物标志物,这些患者在NA治疗期间达到无法检测的HBV DNA水平.
主要方法:
- 在2000年至2024年期间,对311名接受NA治疗的CHB患者进行了回顾性分析.
- 在实现无法检测的HBVDNA时测量血清HBVRNA和HBcrAg.
- 考克斯回归分析以确定HCC发展预测因素.
主要成果:
- 在平均11.0年的随访期间,31名 (10.0%) 患者患有HCC.
- 在病毒抑制下,可量化的HBVRNA (≥10拷贝/毫升) 与更高的HCC发病率 (15年:17.8%对比8.8%,p=0.026) 有显著的关联.
- 可量化的HBVRNA独立预测HCC (aHR=3.313),而HBcrAg没有 (aHR=0.821).
结论:
- 病毒抑制时血清HBVRNA水平是NA治疗的CHB患者中HCC发展的显著预测因素.
- 在预测HCC风险方面,HBV RNA的表现优于HBcrAg.
- 将HBV RNA评估整合到监测策略中可以提高CHB患者的HCC风险分层.
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