Ikeda Kenji, Arase Yasuji, Kobayashi Masahiro, Saitoh Satoshi, Someya Takashi, Hosaka Tetsuya, Sezaki Hitomi, Akuta Norio, Suzuki Yoshiyuki, Suzuki Fumitaka, Kumada Hiromitsu
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Dig Dis Sci. 2006 Mar;51(3):603-9. doi: 10.1007/s10620-006-3177-0.
To elucidate the influence of a glycyrrhizin therapy on hepatocarcinogenesis rate in interferon (IFN)-resistant hepatitis C, we retrospectively analyzed 1249 patients with chronic hepatitis with or without cirrhosis. Among 346 patients with high alanine transaminase value (twice or more of upper limit of normal), 244 patients received intravenous glycyrrhizin injection and 102 patients did not, after judgment of IFN resistance. Crude carcinogenesis rates in the treated and untreated group were 13.3%, 26.0% at the 5th year, and 21.5% and 35.5% at the 10th year, respectively (P = .0210). Proportional hazard analysis using time-dependent covariates disclosed that glycyrrhizin treatment significantly decreased the hepatocarcinogenesis rate (hazard ratio 0.49, 95% confidence interval 0.27-0.86, P = .014) after adjusting the background features with significant covariates. Glycyrrhizin injection therapy significantly decreased the incidence of hepatocellular carcinoma in patients with IFN-resistant active chronic hepatitis C, whose average aminotransferase value was twice or more of upper limit of normal after interferon.
为阐明甘草酸治疗对干扰素(IFN)抵抗性丙型肝炎肝癌发生率的影响,我们回顾性分析了1249例伴有或不伴有肝硬化的慢性肝炎患者。在346例丙氨酸转氨酶值高(两倍或高于正常上限)的患者中,在判定IFN抵抗后,244例患者接受了静脉注射甘草酸,102例患者未接受。治疗组和未治疗组的粗致癌率在第5年分别为13.3%、26.0%,在第10年分别为21.5%和35.5%(P = 0.0210)。使用时间依赖性协变量的比例风险分析显示,在对具有显著协变量的背景特征进行调整后,甘草酸治疗显著降低了肝癌发生率(风险比0.49,95%置信区间0.27 - 0.86,P = 0.014)。甘草酸注射治疗显著降低了IFN抵抗性活动性慢性丙型肝炎患者的肝细胞癌发生率,这些患者在干扰素治疗后平均转氨酶值为正常上限的两倍或更高。