Rino Yasushi, Tarao Kazuo, Morinaga Souichiro, Ohkawa Shinichi, Miyakawa Kaoru, Hirokawa Satoru, Masaki Takahiro, Tarao Norio, Yukawa Norio, Saeki Hiroyuki, Takanashi Yoshinori, Imada Toshio
Department of Surgery, Yokohama City University, School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Anticancer Res. 2006 May-Jun;26(3B):2221-6.
To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C virus-associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had received reduction therapy of the alanine aminotransferase (ALT) levels was performed.
Seventy-four consecutive HCV-LC patients of Child Stage A were followed for >10 years for the development of HCC. They were divided into two groups: in group A, the reduction therapy for the ALT levels was aggressively performed, while in group B, the reduction therapy was not performed aggressively. The patients were subdivided into three sub-groups according to their serum ALT levels. In groups A and B, the high ALT group was comprised, respectively, of nine and five patients whose annual average serum ALT levels were persistently high (> or =80 IU), while the low ALT group was comprised of 19 and 20 patients whose annual average serum ALT levels were persistently low (<80 IU). The remaining eleven and ten patients had annual average serum ALT levels which fluctuated and were unclassified (unclassified group).
In group B, 65.7% of the patients had developed HCC in 13 years, in contrast to only 41.0% of group A (p=0.039). In group A, the median HCC development time was 12.8 years, in contrast to only 3.8 years in group B (p=0.0013). Multivariate analysis demonstrated that the mode of reduction therapy and ALT levels were the significant factors affecting HCC development.
The chances of surviving for more than ten years without developing HCC for HCV-LC patients
为了找到一种预防丙型肝炎病毒相关性肝硬化（HCV-LC）发展为肝细胞癌（HCC）的方法，对接受过丙氨酸氨基转移酶（ALT）水平降低治疗的HCV-LC患者进行了分析。
对74例连续的Child A期HCV-LC患者进行了超过10年的随访，观察HCC的发生情况。他们被分为两组：A组积极进行ALT水平降低治疗，而B组未积极进行降低治疗。根据血清ALT水平将患者细分为三个亚组。在A组和B组中，高ALT组分别由9例和5例患者组成，其年平均血清ALT水平持续较高（≥80 IU），而低ALT组分别由19例和20例患者组成，其年平均血清ALT水平持续较低（<80 IU）。其余11例和10例患者的年平均血清ALT水平波动，未分类（未分类组）。
B组65.7%的患者在13年内发生了HCC，而A组仅为41.0%（p = 0.039）。在A组中，HCC发生的中位时间为12.8年，而B组仅为3.8年（p = 0.0013）。多因素分析表明，降低治疗方式和ALT水平是影响HCC发生的重要因素。
HCV-LC患者在不发生HCC的情况下存活超过十年的几率
