Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index.
Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index.
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DOI：
10.5009/gnl15368
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发表时间：
2016-09-15
期刊：
影响因子：
3.4
通讯作者：
Paik SW
中科院分区：
文献类型：
--
作者：
Lee K;Sinn DH;Gwak GY;Cho HC;Jung SH;Paik YH;Choi MS;Lee JH;Koh KC;Paik SW
在慢性丙型肝炎（CHC）感染的持续病毒学应答（SVR）后，晚期纤维化患者需要定期监测肝细胞癌（HCC）。天冬氨酸转氨酶与血小板比率指数（APRI）是一种简单的非侵入性替代指标，已知可反映纤维化。我们回顾性分析了598例以干扰素为基础的治疗CHC获得SVR的患者。在中位5.1年的随访中，有8例患者被诊断为HCC，5年累积发病率为1.3%。治疗前APRI中位数为0.83，达到SVR后降至0.29（p<0.001）。治疗前和治疗后的指标均与HCC的发展相关。对于治疗前APRI <1.0和≥1.0的患者，5年累积HCC发病率分别为0%和2.8%（p=0.001），而对于治疗后APRI <1.0和≥ 1.0的患者，5年累积HCC发病率分别为0.8%和12.8%（p<0.001）。治疗前APRI在1.0的临界值具有100%的阴性预测值，直到SVR后10年。在达到SVR的CHC患者中观察到HCC发展。治疗前和治疗后的APRI可以对HCC风险进行分层，表明APRI可能是对达到SVR的CHC患者进行HCC风险分类的有用标志物。然而，由于HCC患者数量较少，这一发现需要进一步验证。
Following sustained virological response (SVR) for chronic hepatitis C (CHC) infection, patients with advanced fibrosis require regular monitoring for hepatocellular carcinoma (HCC). The aspartate aminotransferase to platelet ratio index (APRI) is a simple noninvasive surrogate marker known to reflect fibrosis. We retrospectively analyzed 598 patients who achieved SVR with interferon-based therapy for CHC. Over a median of 5.1 years of follow-up, there were eight patients diagnosed with HCC and a 5-year cumulative incidence rate of 1.3%. The median pretreatment APRI was 0.83, which decreased to 0.29 after achieving SVR (p<0.001). Both the pre- and posttreatment indices were associated with HCC development. The 5-year cumulative HCC incidence rates were 0% and 2.8% for patients with pretreatment APRI <1.0 and ≥1.0, respectively (p=0.001) and 0.8% and 12.8% for patients with posttreatment APRI <1.0 and ≥1.0, respectively (p<0.001). Pretreatment APRI at a cutoff of 1.0 had a 100% negative predictive value until 10 years after SVR. HCC development was observed among CHC patients who achieved SVR. The pre- and post-treatment APRI could stratify HCC risk, indicating that the APRI could be a useful marker to classify HCC risk in CHC patients who achieved SVR. However, given the small number of HCC patients, this finding warrants further validation.
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影响因子：
13.5
作者：
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