Decreased risk of hepatocellular carcinoma in patients with chronic hepatitis C whose serum alanine aminotransferase levels became less than twice the upper limit of normal following interferon therapy
Decreased risk of hepatocellular carcinoma in patients with chronic hepatitis C whose serum alanine aminotransferase levels became less than twice the upper limit of normal following interferon therapy
复制标题
DOI：
10.1111/j.1478-3231.2005.01028.x
复制
发表时间：
2005-02-01
影响因子：
6.7
通讯作者：
Arakawa, Y
中科院分区：
文献类型：
--
作者：
Moriyama, M;Matsumura, H;Arakawa, Y
目的：根据丙氨酸转氨酶（ALT）水平评估丙型病毒慢性肝炎（CH）和肝硬化（LC）患者干扰素（IFN）治疗后肝细胞癌（HCC）的发生率。患者：269 名患有 C 病毒 CH 和 LC 的患者接受了天然 IFN-α 治疗。根据病毒学应答和 ALT 水平，使用以下组评估 IFN 治疗的疗效：病毒学持续应答者 (VSR)；生化持续反应者（BSR）；部分缓解者 (PR)，由血清 ALT 水平后来复发的 BSR 患者组成；无反应者 (NR)1，其中包括血清 ALT 水平通常低于 80 IU/l 的患者； NR2、NR 的 ALT 水平持续超过 80 IU/l。结果：269 名患者中，22 名（8.2%）在 IFN 治疗后发展为 HCC。 VSR、BR、PR、NR1、NR2 组中 HCC 的发生率（%/患者/年）分别为 0.78%、0%、0%、0.17%、4.68%。多变量分析显示，ALT水平升高至80 IU/l以上是HCC发生的重要危险因素。结论：我们的结论是，IFN 治疗后 ALT 水平低于正常上限两倍的患者从 C 病毒慢性肝病进展为 HCC 的风险降低。
Aim: The incidence of hepatocellular carcinoma (HCC) in C-viral chronic hepatitis (CH) and liver cirrhosis (LC) patients after interferon (IFN) therapy was evaluated according to alanine aminotransferase (ALT) levels. Patients: Two hundred sixty-nine patients with C-viral CH and LC were treated with natural IFN-alpha. The efficacy of IFN therapy was evaluated based on virologic response and ALT levels using the following groups: virologic-sustained responders (VSR); biochemical-sustained responders (BSR); partial responders (PR), which consisted of BSR patients whose serum ALT levels later relapsed; non-responders (NR)1, which included patients with serum ALT levels that were usually less than 80 IU/l; and NR2, NR with ALT levels persistently more than 80 IU/l. Results: Of the 269 patients, 22 (8.2%) developed HCC after IFN therapy. The incidence of HCC (%/patient/year) was 0.78%, 0%, 0%, 0.17%, 4.68% in VSR, BR, PR, NR1, NR2, respectively. Multivariate analysis revealed that an increase in ALT levels to more than 80 IU/l is an important risk factor for the occurrence of HCC. Conclusions: We concluded that the patients with ALT levels less than twice the upper limit of normal after IFN therapy have a reduced risk of progression to HCC from C-viral chronic liver disease.