Risk Assessment of Hepatitis B Virus-Related Hepatocellular Carcinoma Development Using Liver Stiffness Measurement (FibroScan)
Risk Assessment of Hepatitis B Virus-Related Hepatocellular Carcinoma Development Using Liver Stiffness Measurement (FibroScan)
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DOI：
10.1002/hep.24121
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发表时间：
2011-03-01
期刊：
影响因子：
13.5
通讯作者：
Han, Kwang-Hyub
中科院分区：
文献类型：
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作者：
Jung, Kyu Sik;Kim, Seung Up;Han, Kwang-Hyub
使用FibroScan的肝脏硬度测量(LSM)可以准确评估慢性丙型肝炎患者的肝纤维化程度和肝细胞癌(HCC)的发展风险。这项研究探讨了LSM作为预测慢性乙型肝炎(CHB)患者肝细胞癌发展的有用指标。在这项前瞻性研究中，共有1130名在2005年5月至2007年12月期间接受LSM治疗的未经活检证实的CHB患者入选。在实施LSM后，患者接受定期随访，作为检测肝细胞癌监测计划的一部分。患者的平均年龄(767名男性，363名女性)为50.2岁，LSM中位数为7.7kPa.672名患者(59.5%)在登记前或登记后接受了抗病毒治疗。在随访期(中位数30.7个月；范围24.0-50.9个月)中，57名患者发展为肝癌(每1人年2.0%)。肝癌1、2、3年累积发病率分别为0.80%、3.26%、5.98%。在多因素分析中，结合高龄、男性、重度饮酒(80克/天)、血清白蛋白和乙肝e抗原阳性的患者发生肝癌的风险显著增加，危险比如下：低气压8.1-13千帕3.07(95%可信区间1.01-9.31；P=0.047)；低气压13-18千帕4.68(95%可信区间1.4-15.64；P=0.012)；LSM 18.1-23kPa5.55(95%可信区间1.53-20.04；P=0.009)；LSM>；23kPa6.6(95%可信区间1.83-23.84；P=0.004)。结论：我们的数据提示LSM可以作为预测慢性乙肝患者发生肝细胞癌的有用指标。(《肝病》2011；53：885-894)
Liver stiffness measurement (LSM) using FibroScan accurately assesses the degree of liver fibrosis and the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C. This study investigated the usefulness of LSM as a predictor of HCC development in patients with chronic hepatitis B (CHB). A total of 1,130 patients with non-biopsy-proven CHB who underwent LSM between May 2005 and December 2007 were enrolled in this prospective study. After LSM was performed, patients attended regular follow-up as part of a surveillance program for the detection of HCC. The mean age of the patients (767 men, 363 women) was 50.2 years, and the median LSM was 7.7 kPa. Six hundred seventy-two (59.5%) patients received antiviral treatment before or after enrollment. During the follow-up period (median, 30.7 months; range, 24.0-50.9 months), HCC developed in 57 patients (2.0% per 1 person-year). The 1-, 2-, and 3-year cumulative incidence rates of HCC were 0.80%, 3.26%, and 5.98%, respectively. On multivariate analysis, together with old age, male sex, heavy alcohol consumption (> 80 g/day), serum albumin, and hepatitis B e antigen positivity, patients with a higher LSM (> 8 kPa) were at a significantly greater risk of HCC development, with the following hazard ratios: 3.07 (95% confidence interval [CI], 1.01-9.31; P = 0.047) for LSM 8.1-13 kPa; 4.68 (95% CI, 1.40-15.64; P = 0.012) for LSM 13.1-18 kPa; 5.55 (95% CI, 1.53-20.04; P = 0.009) for LSM 18.1-23 kPa; and 6.60 (95% CI, 1.83-23.84; P = 0.004) for LSM > 23 kPa. Conclusion: Our data suggest that LSM could be a useful predictor of HCC development in patients with CHB. (HEPATOLOGY 2011;53:885-894)