Screening for hepatocellular carcinoma among veterans with hepatitis C on disease stage, treatment received, and survival
Screening for hepatocellular carcinoma among veterans with hepatitis C on disease stage, treatment received, and survival
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DOI：
10.1016/j.cgh.2007.01.014
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发表时间：
2007-04-01
影响因子：
12.6
通讯作者：
Papadopoulos, Kyriakos P.
中科院分区：
文献类型：
--
作者：
Leykum, Luci K.;El-Serag, Hashem B.;Papadopoulos, Kyriakos P.
背景与目的：肝细胞癌（hepatocellular carcinoma，HCC）的发病率日益增高.尽管美国肝病研究协会建议进行HCC筛查，但美国国家癌症研究所不建议进行筛查。筛查是否有益是一个重要的问题。本研究的目的是检查筛查的决定因素，以及筛查对美国退伍军人疾病分期、接受治疗和生存率的影响。研究方法：使用退伍军人事务部国家丙型肝炎登记处确定了在南德克萨斯州退伍军人医疗保健系统接受治疗的丙型肝炎和HCC患者。通过病历审查确定筛选状态。评估了筛选的潜在决定因素。根据诊断时的疾病分期、接受的治疗和生存率，对筛选和未筛选的患者进行比较。结果：72例患者被确定并纳入分析，其中只有16例（22%）进行了筛选。在诊断前由肝病专家检查的患者更有可能接受筛查。所有筛查患者均被诊断为早期疾病，而未筛查患者的22%（P
Background & Aims: The incidence of hepatocellular carcinoma (HCC) is increasing. Despite recommendations for HCC screening from the American Association for the Study of Liver Disease, the National Cancer Institute does not recommend screening. The question of whether screening is of benefit is an important one. The purpose of this study was to examine the determinants of screening, as well as the impact of screening on disease stage, treatment received, and survival in a US veteran population. Methods: Patients with hepatitis C and HCC who receive care in the South Texas Veteran Health Care System were identified using the Veterans Affairs national hepatitis C registry. Screening status was determined by chart review. Potential determinants of screening were assessed. Screened and unscreened patients were compared on the basis of disease stage at diagnosis, treatment: received, and survival. Results: Seventy-two patients were identified and included in the analysis, of whom only 16 (22%) were screened. Patients seen by a hepatologist before diagnosis were more likely to be screened. All screened patients were diagnosed with early stage disease, compared with 22% of unscreened patients (P