正确记录:在患有HCV相关HCC的患者中的实用性和结果
María Fernanda Guerra-Veloz1, Sital Shah1, Beatrice Emmanouil2
1Institute of Liver Studies, King's College Hospital, London, UK.
Journal of viral hepatitis
|February 10, 2026
概括
直接作用抗病毒 (DAA) 疗法对大多数患有型肝炎病毒 (HCV) 相关肝癌 (HCC) 的患者有效,达到高治愈率. 然而,晚期HCC患者的治疗成功率较低,影响整体存活率.
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:
- 在患有活性肝细胞癌 (HCC) 的患者中,直接作用抗病毒 (DAA) 治疗的有效性尚不清楚.
- 英国国家卫生服务局 (NHS) 现在批准DAA治疗所有病毒性患者,包括患有HCC的患者.
研究的目的:
- 评估DAA疗法在患有HCV相关HCC的患者中的实际治疗结果.
- 为了比较HCV护理级联和持续病毒学响应 (SVR) 率在HCC患者和没有HCC的晚期纤维化/肝硬化患者之间.
主要方法:
- 使用英格兰东南部国家C型肝炎登记处 (2016-2023) 的回顾性研究.
- 包括1518名接受DAA治疗的HCVRNA阳性患者,包括HCC队列 (7.6%) 和非HCC队列 (92.4%).
- 评估了包括SVR率和总生存率 (OS) 在内的初级结局,基于巴塞罗那诊所肝癌 (BCLC) 阶段.
主要成果:
- 在HCC队列中,SVR率为87%,而非HCC队列中为94.5% (p=0.003).
- 多变量分析确定了HCC存在作为与较低的SVR概率相关的独立因素 (OR 0.4;p=0.029).
- 根据BCLC阶段 (BCLC 0-A的80个月到BCLC D的3个月),中位数的生存寿命显著变化,在达到SVR的患者中观察到更长的生存寿命.
结论:
- 在与HCV相关的HCC患者中,DAA治疗的高吸收率和完成率导致可接受的治愈率.
- 对于HCV/HCC患者来说,DAA治疗是适当的临床标准,以改善结果,但对于寿命非常短的人来说,应避免使用.
- 治疗结果和生存率受到HCC阶段和SVR成就的显著影响.
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