Risk factors for hepatocellular carcinoma in patients with drug-resistant chronic hepatitis B
Risk factors for hepatocellular carcinoma in patients with drug-resistant chronic hepatitis B
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DOI：
10.3748/wjg.v19.i40.6834
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发表时间：
2013-10-28
影响因子：
4.3
通讯作者：
Rew, Jong Sun
中科院分区：
文献类型：
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作者：
Jun, Chung Hwan;Hong, Hyoung Ju;Rew, Jong Sun
目的：目的探讨耐药慢性B肝炎（CHB）患者发生肝细胞癌（HCC）的危险因素及特点。将患者分为两组：HCC组（n = 57）和非HCC组（n = 375）。使用逻辑回归对不同患者和病毒特征的两组进行比较，以确定HCC的相关危险因素。其次，原发性CHB的HCC患者的患者和肿瘤特征（N组，n = 117）与HCC组进行比较（R组，n = 57），以确定它们之间HCC特征的任何差异。年龄、血小板计数、甲胎蛋白（AFP）、HBeAg阳性率、HBeAg血清转换率、病毒学应答、Child-Pugh评分、rtM 204 I的存在以及非HCC和HCC组中抗病毒治疗的持续时间。肝硬化、年龄（> 50岁）、HBeAg（+）、病毒学无应答状态和rtM 204 I突变体是HCC发展的独立危险因素。与N组相比，R组血清C反应蛋白（CRP）和AFP水平较低，肿瘤分期较早，平均肿瘤监测时间较短。然而，总的随访时间是没有显着差异，两组之间。结论：13.2%的耐药慢性乙型肝炎患者发展为肝癌。年龄、肝硬化、YIDD状态、HBeAg状态和病毒学应答与HCC风险相关。具有耐药CHB和这些临床因素的患者可能受益于更密切的HCC监测。(C)2013年百世登。All rights reserved.
AIM: To investigate the risk factors and characteristics of hepatocellular carcinoma (HCC) in the patients with drug-resistant chronic hepatitis B (CHB).METHODS: A total of 432 patients with drug-resistant CHB were analyzed retrospectively from January 2004 to December 2012. The patients were divided into two groups: the HCC group (n = 57) and the non-HCC group (n = 375). Two groups compared using logistic regression for various patients and viral characteristics in order to identify associated risk factors for HCC. Secondarily, patient and tumor characteristics of HCC patients with naive CHB (N group, n = 117) were compared to the HCC group (R group, n = 57) to identify any difference in HCC characteristics between them.RESULTS: A significant difference was found for age, platelet count, alpha-fetoprotein (AFP), positivity of HBeAg, seroconversion rate of HBeAg, virologic response, the Child-Pugh score, presence of rtM204I, and the duration of antiviral treatment in non-HCC and HCC group. Cirrhosis, age (> 50 years), HBeAg (+), virologic non-responder status, and rtM204I mutants were independent risk factors for the development of HCC. The R group had lower serum C-reactive protein (CRP) and AFP levels, earlier stage tumors, and a shorter mean tumor surveillance period than the N group. However, the total follow-up duration was not significantly different between the two groups.CONCLUSION: 13.2% of patients with drug-resistant CHB developed HCC. Age, cirrhosis, YIDD status, HBeAg status, and virologic response are associated with risk of HCC. Patients with drug-resistant CHB and these clinical factors may benefit from closer HCC surveillance. (C) 2013 Baishideng. All rights reserved.