Serum hepatitis B core-related antigen predicts hepatocellular carcinoma in hepatitis B e antigen-negative patients
Serum hepatitis B core-related antigen predicts hepatocellular carcinoma in hepatitis B e antigen-negative patients
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DOI：
10.1007/s00535-020-01700-z
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发表时间：
2020-06-17
影响因子：
6.3
通讯作者：
Wong, Grace Lai-Hung
中科院分区：
文献类型：
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作者：
Liang, Lilian Yan;Wong, Vincent Wai-Sun;Wong, Grace Lai-Hung
背景乙型肝炎B核心相关抗原（HBcrAg）是一种新型血清病毒标志物。近年来的研究表明，其水平与慢性B型肝炎（CH B）患者发生肝细胞癌（HCC）的风险相关。我们的目的是评估基线时血清HBsAg和HBcrAg水平预测HCC的准确性。方法选取2005年12月以来接受核苷（酸）类似物（NA）治疗的慢性乙型肝炎患者1400例。检索他们基线时储存的血清样本以测量HBsAg和HBcrAg水平。主要终点是HCC的累积发生率。结果85例（6.1%）患者在平均（+/- SD）45 +/- 20个月的随访期间发生了HCC。多变量分析显示，基线时血清HBcrAg水平高于2.9 log 10 U/mL是B e抗原（HBeAg）阴性患者发生HCC的独立危险因素（校正后风险比2.13，95%CI 1.10- 4.14，P = 0.025）。HBcrAg高于2.9 log（10）U/mL可将HBeAg阴性、PAGE-B评分高的患者（Kaplan-Meier分析P = 0.024）和可能存在HCC的患者（P = 0.08）的HCC风险分层。在所有患者或任何亚组中，血清HBsAg水平与HCC的风险均无相关性。结论血清HBcrAg水平可准确预测NA治疗HBeAg阴性CHB患者发生HCC的风险。
Background Hepatitis B core-related antigen (HBcrAg) is a novel serum viral marker. Recent studies showed that its level correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to evaluate the accuracy of serum HBsAg and HBcrAg levels at baseline to predict HCC. Methods 1400 CHB patients who received nucleos(t)ide analogues (NA) treatment since December 2005 were included. Their stored serum samples at baseline were retrieved to measure HBsAg and HBcrAg levels. The primary endpoint was the cumulative incidence of HCC. Results 85 (6.1%) patients developed HCC during a mean (+/- SD) follow-up duration of 45 +/- 20 months. Serum HBcrAg level above 2.9 log10 U/mL at baseline was an independent factor for HCC in hepatitis B e antigen (HBeAg)-negative patients by multivariable analysis (adjusted hazard ratio 2.13, 95% CI 1.10-4.14,P = 0.025). HBcrAg above 2.9 log(10)U/mL stratified the risk of HCC in HBeAg-negative patients with high PAGE-B score (P = 0.024 by Kaplan-Meier analysis), and possibly in cirrhotic patients (P = 0.08). Serum HBsAg level did not show any correlation with the risk of HCC in all patients or any subgroups. Conclusion Serum HBcrAg level predicts the risk of HCC accurately in NA-treated HBeAg-negative CHB patients.