Hepatocellular carcinoma in children and young patients with chronic HBV infection and the usefulness of alpha-fetoprotein assessment.
Hepatocellular carcinoma in children and young patients with chronic HBV infection and the usefulness of alpha-fetoprotein assessment.
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DOI：
10.1002/cam4.917
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发表时间：
2016-11
期刊：
影响因子：
4
通讯作者：
Tanaka, Yasuhito
中科院分区：
文献类型：
--
作者：
Tajiri, Hitoshi;Takano, Tomoko;Tanaka, Hideo;Ushijima, Kosuke;Inui, Ayano;Miyoshi, Yoko;Ozono, Keiichi;Abukawa, Daiki;Endo, Takeshi;Brooks, Stephen;Tanaka, Yasuhito
本研究的目的是阐明儿童期持续HBV感染的肝细胞癌（HCC）患者的临床特征，并探讨在这一人群中评估甲胎蛋白（AFP）的有效性。对慢性HBV感染儿童进行了全国性多中心调查。在548例患者中，15例发生HCC的中位年龄为15岁（范围9-36岁），其中男性13例，女性2例。病例对照比较显示，HBeAg血清转化和肝硬化与HCC的发生有关。在15例HCC患者中，5例接受干扰素治疗，没有一例对干扰素治疗有反应，而对照组17例有反应的患者中有12例对干扰素治疗有反应。在这15名患者中，有10人死亡，其中9人在确诊为HCC之前从未去过任何医疗机构，而其余5名幸存患者从未停止过诊所就诊。AFP评估的有效性可以通过以下发现得到证明：AFP水平在所有HCC病例中均升高，存活患者在诊断前检测到AFP水平升高，并且AFP作为HCC诊断测试的敏感性在40例患者中非常高，其中包括我们的14例和从文献中收集的另外26例。HBeAg血清转化和肝硬化与HCC的发生有关。在跟踪儿童期慢性HBV感染的儿童和青少年患者时，定期检测AFP可能有助于观察HCC的发生
The aims of the study were to elucidate the clinical characteristics of patients who developed hepatocellular carcinoma (HCC) related to persistent HBV infection since childhood and to investigate usefulness of assessing alpha‐fetoprotein (AFP) in this population. A nationwide multicenter survey of children with chronic HBV infection was performed. Among 548 patients, 15 patients developed HCC at the median age of 15 years (range 9–36), including 13 males and 2 females. A case–control comparison showed that HBeAg seroconversion and liver cirrhosis were associated with the occurrence of HCC. Of the 15 HCC patients, 5 were treated with interferon and none of them responded to interferon therapy as compared with 12 of the 17 responders in the control group. Of the 15 patients, 10 died and 9 of the 10 who died never visited any medical facilities until diagnosis of HCC, while the remaining 5 surviving patients never stopped their clinic visits. The usefulness of AFP assessment was shown by the findings that AFP levels were elevated in all HCC cases, that elevations in AFP levels were detected prior to the diagnosis in the surviving patients, and that sensitivity of AFP as a diagnostic test for HCC was very high among 40 patients including our 14 and an additional 26 collected from the literature. HBeAg seroconversion and liver cirrhosis are associated with the occurrence of HCC. Regular measurement of AFP might be helpful to watch for the occurrence of HCC when following children and young patients with chronic HBV infection since childhood
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