Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy
Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy
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DOI：
10.1002/cncr.20537
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发表时间：
2004-10-01
期刊：
影响因子：
6.2
通讯作者：
Okanoue, T
中科院分区：
文献类型：
--
作者：
Makiyama, A;Itoh, Y;Okanoue, T
背景本研究的目的是确定干扰素治疗慢性丙型肝炎后发生肝细胞癌的持续应答者的特征。本研究包括3626例接受干扰素单药治疗的慢性丙型肝炎患者。考克斯比例风险分析用于比较持续应答者发生和未发生肝细胞癌，以及非持续应答者发生肝细胞癌的多中心回顾性队列研究。在1197例持续应答者中，27例患者发生肝细胞癌（2.3%）。与未发生肝细胞癌的持续应答者相比，发生肝细胞癌的患者多为男性（P = 0.0212）、老年人（P = 0.0068）和干扰素治疗前有晚期组织学疾病（P = 0.0345）。相反，与无持续应答的肝细胞癌患者相比，持续应答的患者在开始干扰素治疗时（P = 0.0552）和检测到肝细胞癌时（P = 0.0593）倾向于年龄较大，并且他们也主要是男性（P = 0.0507）。两组患者的组织学分期、干扰素治疗开始时的血清转氨酶水平、肿瘤检出时间、肿瘤大小均无显著差异。在干扰素治疗后发生肝细胞癌的高危组中，持续应答者年龄较大，多为男性，且组织学疾病分期较晚期。此类患者在完成干扰素治疗后应定期仔细随访> 10年。(C)2004年美国癌症协会。
BACKGROUND. The objective of the current study was to determine the characteristic features of sustained responders who develop hepatocellular carcinoma after treatment with interferon for chronic hepatitis C.METHODS. This study included 3626 patients with chronic hepatitis C who had received interferon monotherapy. Cox proportional hazards analysis was used to compare sustained responders who did and did not develop hepatocellular carcinoma, and nonsustained responders who developed hepatocellular carcinoma in a multicenter, retrospective cohort study.RESULTS. Among 1197 sustained responders, 27 patients developed hepatocellular carcinoma (2.3%). Compared with sustained responders who did not develop hepatocellular carcinoma, patients who developed disease more often were male (P = 0.0212), were older (P = 0.0068), and had advanced-stage histologic disease before interferon therapy (P = 0.0345). Conversely, compared with patients with hepatocellular carcinoma who were not sustained responders, patients who were sustained responders tended to be older at the time of the initiation of interferon therapy (P = 0.0552) and at the time hepatocellular carcinoma was detected (P = 0.0593), and they also were predominantly male (P = 0.0507). The histologic staging and serum aminotransferase levels at the initiation of interferon therapy, the interval to the detection of tumor, and the tumor size showed no significant differences between the two groups.CONCLUSIONS. Sustained responders in the group at high risk for developing hepatocellular carcinoma after interferon therapy were older, more often were male, and had more advanced histologic disease stage. Such patients should be followed carefully periodically for > 10 years after they complete interferon therapy. (C) 2004 American Cancer Society.