Role of vitamin K2 in the development of hepatocellular carcinoma in women with viral cirrhosis of the liver
Role of vitamin K2 in the development of hepatocellular carcinoma in women with viral cirrhosis of the liver
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DOI：
10.1001/jama.292.3.358
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发表时间：
2004-07-21
影响因子：
120.7
通讯作者：
Nishiguchi, S
中科院分区：
文献类型：
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作者：
Habu, D;Shiomi, S;Nishiguchi, S
先前的研究结果表明，维生素K-2（甲萘醌）可能在控制细胞生长中起作用。目的确定维生素K-2是否对女性病毒性肝硬化患者发生肝细胞癌具有预防作用。设计，设置，40名被诊断为病毒性肝硬化的妇女在1996年至1998年期间被收治到一所大学医院，分配到治疗组或对照组。该试验的最初目的是评估维生素K-2对病毒性肝硬化女性骨质流失的长期影响。然而，研究参与者也满足检查此类治疗对肝细胞癌发展的影响所需的标准。干预措施治疗组21例，给予维生素K-2 45 mg/d。在治疗组和对照组的参与者接受对症治疗，治疗腹水，如果有必要，和dietary advice.Main结果测量肝细胞癌患者的累积比例。结果肝细胞癌检测在2的21名妇女给予维生素K-2和9的19名妇女在对照组。治疗组中肝细胞癌患者的累积比例较小（对数秩检验，P=.02）。在单变量分析中，治疗组与对照组相比发生肝细胞癌的风险比为0.20（95%置信区间[Cl]，0.04-0.91; P= 0.04）。在校正年龄、丙氨酸氨基转移酶活性、血清白蛋白、总胆红素、血小板计数、甲胎蛋白和干扰素α治疗史的多变量分析中，给予维生素K-2的患者发生肝细胞癌的风险比为0.13结论维生素K-2对女性病毒性肝硬化患者肝细胞癌的发生有一定的预防作用。
Context Previous findings indicate that vitamin K-2 (menaquinone) may play a role in controlling cell growth.Objective To determine whether vitamin K-2 has preventive effects on the development of hepatocellular carcinoma in women with viral cirrhosis of the liver.Design, Setting, and Participants Forty women diagnosed as having viral liver cirrhosis were admitted to a university hospital between 1996 and 1998 and were randomly assigned to the treatment or control group. The original goal of the trial was to assess the long-term effects of vitamin K-2 on bone loss in women with viral liver cirrhosis. However, study participants also satisfied criteria required for examination of the effects of such treatment on the development of hepatocellular carcinoma. Interventions The treatment group received 45 mg/d of vitamin K-2 (n=21). Participants in the treatment and control groups received symptomatic therapy to treat ascites, if necessary, and dietary advice.Main Outcome Measure Cumulative proportion of patients with hepatocellular carcinoma.Results Hepatocellular carcinoma was detected in 2 of the 21 women given vitamin K-2 and 9 of the 19 women in the control group. The cumulative proportion of patients with hepatocellular carcinoma was smaller in the treatment group (log-rank test, P=.02). On univariate analysis, the risk ratio for the development of hepatocellular carcinoma in the treatment group compared with the control group was 0.20 (95% confidence interval [Cl], 0.04-0.91; P=.04). On multivariate analysis with adjustment for age, alanine aminotransferase activity, serum albumin, total bilirubin, platelet count, alpha-fetoprotein, and history of treatment with interferon alfa, the risk ratio for the development of hepatocellular carcinoma in patients given vitamin K-2 was 0.13 (95% Cl, 0.02-0.99; P=.05).Conclusion There is a possible role for vitamin K-2 in the prevention of hepatocellular carcinoma in women with viral cirrhosis.