Tumor behavior of hepatocellular carcinoma after hepatitis C treatment by direct-acting antivirals: comparative analysis with non-direct-acting antivirals-treated patients
Tumor behavior of hepatocellular carcinoma after hepatitis C treatment by direct-acting antivirals: comparative analysis with non-direct-acting antivirals-treated patients
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DOI：
10.1097/meg.0000000000001264
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Elbaz, Tamer M.
中科院分区：
文献类型：
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作者：
Abdelaziz, Ashraf O.;Nabil, Mohamed M.;Elbaz, Tamer M.
关于直接作用抗病毒药物（DAAs）治疗肝细胞癌（HCC）行为的报道很少。目的分析丙型肝炎病毒（HCV）诱导的肝癌患者在接受DAAs治疗和未接受DAAs治疗时肿瘤行为的差异。患者和方法本病例对照研究包括接受通用daa治疗的hcv相关HCC患者（I组）和同期就诊的所有未接受daa治疗的HCC患者（II组）。比较两组患者及肿瘤特征、治疗方式及转归。结果I组89例，II组207例。在HCC数量和大小方面，两组间无显著差异。组1表现为浸润性更强的HCC模式，而组2则有更明确的病灶。I组门静脉血栓及明显淋巴结病变发生率明显高于对照组（P=0.03、0.03）。ⅰ组血清甲胎蛋白水平显著高于对照组（P=0.02）。这些因素显著影响HCC治疗效果（P=0.03）。I组和II组完全缓解的发生率分别为47.2%和49.8%，而不完全缓解的发生率分别为12.4%和25.1%。支持治疗组占40.4%，组占25.1%。结论经daa治疗的患者在门静脉血栓形成、恶性淋巴结病变、HCC影像学特征等方面的HCC行为更具侵袭性，影响了消融的机会和治疗效果。版权所有2018威科集团有限公司版权所有。
Introduction Scarce reports have commented on hepatocellular carcinoma (HCC) behavior after direct-acting antivirals (DAAs). Aim To analyze differences in tumor behavior between patients with hepatitis C virus (HCV)-induced HCC and were either treated or not using DAAs. Patients and methods This case-control study includes patients with HCV-related HCC who received generic DAAs (group I) and all non-DAA treated patients with HCC who presented to our clinic during the same period (group II). Patient and tumor characteristics, treatment types and outcome were compared between the two groups. Results Group I included 89 patients and group II included 207 patients. No significant difference was detected between groups regarding HCC number or size. Group I showed a more infiltrative HCC pattern, whereas group II had more circumscribed and delineated lesions. The incidence of portal vein thrombosis and significant lymphadenopathy was significantly higher in group I (P=0.03 and 0.03, respectively). Serum levels of alpha-fetoprotein were significantly higher in group I (P=0.02). These factors significantly affected the response to HCC management (P=0.03). Incidence of complete responses were 47.2 and 49.8% for groups I and II, respectively, whereas incomplete responses were 12.4 and 25.1%, respectively. Supportive treatment was applied to 40.4% in group I and 25.1% in group II. Conclusion HCC behavior was more aggressive in DAA-treated patients regarding portal vein thrombosis, malignant lymphadenopathy, and HCC imaging characteristics, which affected the chance of ablation and the treatment response. Copyright (c) 2018 Wolters Kluwer Health, Inc. All rights reserved.