Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis C
Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis C
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DOI：
10.1002/hep.26087
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发表时间：
2013-03-01
期刊：
影响因子：
13.5
通讯作者：
Kobayashi, Tetsuro
中科院分区：
文献类型：
--
作者：
Arase, Yasuji;Kobayashi, Mariko;Kobayashi, Tetsuro
本回顾性队列研究的目的是评估干扰素（IFN）治疗终止后日本丙型肝炎病毒（HCV）患者恶性肿瘤的累积发展发生率和预测因素。共有4302名接受干扰素治疗的hcv阳性患者入组。平均观察期8.1年。主要结果是首次出现恶性肿瘤。采用Kaplan-Meier法和Cox比例风险分析进行评价。共有606例患者发生恶性肿瘤：393例发展为肝细胞癌（HCC）， 213例发展为HCC以外的恶性肿瘤。5年HCC累积发展率为4.3%，10年为10.5%，15年为19.7%。当存在以下特征时，HCC发生显著（P < 0.05）：组织学分期晚期，未达到持续病毒学反应，男性，50岁以上，总酒精摄入量200 kg，存在2型糖尿病（T2DM）。T2DM导致HCC发展增加1.73倍。在T2DM患者中，当患者的平均血红蛋白A1c （HbA1c）水平为
The aim of this retrospective cohort study was to assess the cumulative development incidence and predictive factors for malignancies after the termination of interferon (IFN) therapy in Japanese patients for hepatitis C virus (HCV). A total of 4,302 HCV-positive patients treated with IFN were enrolled. The mean observation period was 8.1 years. The primary outcome was the first onset of malignancies. Evaluation was performed using the Kaplan-Meier method and Cox proportional hazard analysis. A total of 606 patients developed malignancies: 393 developed hepatocellular carcinoma (HCC) and 213 developed malignancies other than HCC. The cumulative development rate of HCC was 4.3% at 5 years, 10.5% at 10 years, and 19.7% at 15 years. HCC occurred significantly (P < 0.05) when the following characteristics were present: advanced histological staging, sustained virological response not achieved, male sex, advanced age of 50 years, total alcohol intake of 200 kg, and presence of type 2 diabetes (T2DM). T2DM caused a 1.73-fold enhancement in HCC development. In patients with T2DM, HCC decreased when patients had a mean hemoglobin A1c (HbA1c) level of