Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long-term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis
Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long-term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis
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DOI：
10.1002/hep.510290439
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发表时间：
1999-04-01
期刊：
影响因子：
13.5
通讯作者：
Kawanishi, M
中科院分区：
文献类型：
--
作者：
Ikeda, K;Saitoh, S;Kawanishi, M
干扰素（IFN）的活性尚未从慢性丙型肝炎患者体内癌症预防的角度阐明。对1,643例慢性丙型肝炎患者的肝细胞癌变率进行了统计学分析，其中1,191例接受了干扰素治疗，452例未接受干扰素治疗。治疗组和未治疗组的肝癌发生率在第5年末分别为2.1%和4.8%，在第10年末分别为7.6%和12.4%（P = 0.0036）。多变量分析显示，与未经治疗的患者相比，干扰素使致癌风险略微降低33%（P = 0.14），调整了年龄、纤维化分期、性别和γ-谷氨酰转肽酶（GGTP）值的混杂效应。在1,191例IFN治疗的患者中，461例患者获得了持续的丙型肝炎病毒（HCV）RNA丢失，另外145例患者保持了正常的丙氨酸转氨酶（ALT）值而没有HCV RNA丢失。这606例ALT持续正常伴或不伴HCV-RNA清除的患者的致癌风险显著低于未经治疗的患者（风险比：0.32; P = 0.012）和转氨酶异常组。在慢性丙型肝炎患者中，IFN显著降低ALT正常或持续低值患者的肝细胞癌发生率。
The activity of interferon (IFN) is not elucidated from the viewpoint of cancer prevention in chronic hepatitis C patients en masse. The hepatocellular carcinogenesis rate was analyzed statistically in 1,643 patients with chronic hepatitis C: 1,191 patients with IFN therapy and 452 without IFN therapy. Hepatocellular carcinogenesis rates in the treated and untreated groups were 2.1% and 4.8% at the end of the 5th year, and 7.6% and 12.4% at the 10th year, respectively (P =.0036). Multivariate analysis showed that IFN slightly decreased the risk of carcinogenesis by 33%, compared with that of untreated patients (P =.14), adjusting for the confounding effects of age, fibrotic stage, gender, and gamma-glutamyl transpeptidase (GGTP) value. Among 1,191 patients with IFN, 461 patients attained persistent loss of hepatitis C virus (HCV) RNA, and the other 145 patients retained normal alanine transaminase (ALT) values without loss of HCV RNA. The hazard of carcinogenesis in these 606 patients with persistent normal ALT with or without HCV-RNA clearance was significantly lower than that of untreated patients (hazard ratio: 0.32; P =.012) and that of the abnormal aminotransferase group. Among patients with chronic hepatitis C, IFN significantly decreased the hepatocellular carcinogenesis rate in those patients with normal or persistent low ALT values.