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慢性丙型肝炎患者肝细胞癌消融治疗后采用干扰素治疗进行复发的二级预防。

Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients.

作者信息

Ishikawa Toru

机构信息

Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan.

出版信息

World J Gastroenterol. 2008 Oct 28;14(40):6140-4. doi: 10.3748/wjg.14.6140.

Abstract

Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide. Interferon (IFN) therapy decreases the incidence of HCC in patients with chronic hepatitis C. Prevention of chronic-hepatitis-C-related HCC is one of the most important issues in current hepatology. We have previously reported that male gender and high titer of hepatitis C virus (HCV) RNA are predictive factors for the development of HCC in HCV-related cirrhosis. Clinical efforts at eradicating or reducing the viral load may reduce the risk for HCC. Furthermore, because HCC often recurs after ablation therapy, we performed a trial of IFN in patients with chronic liver disease caused by HCV to see whether IFN therapy decreases recurrence after ablation therapy of HCV-related HCC. By using IFN therapy as a secondary prevention, patients with HCC who had received complete tumor ablation showed better survival, primarily as a result of the preservation of liver function and also probably prevention of recurrence. Postoperative IFN therapy appears to decrease recurrence after ablation therapy such as radiofrequency ablation (RFA) therapy of HCV-related HCC. We believe that there is a survival benefit in secondary prevention using IFN therapy. However, a controlled study is essential to obtain conclusive evidence of the efficacy of this strategy.

摘要

慢性丙型肝炎是全球肝细胞癌(HCC)的主要病因。干扰素(IFN)治疗可降低慢性丙型肝炎患者发生HCC的发生率。预防慢性丙型肝炎相关的HCC是当前肝病学中最重要的问题之一。我们之前曾报道,男性和高滴度丙型肝炎病毒(HCV)RNA是HCV相关肝硬化患者发生HCC的预测因素。根除或降低病毒载量的临床努力可能会降低HCC的风险。此外,由于HCC在消融治疗后常复发,我们对由HCV引起的慢性肝病患者进行了一项IFN试验,以观察IFN治疗是否能降低HCV相关HCC消融治疗后的复发率。通过将IFN治疗用作二级预防,接受完全肿瘤消融的HCC患者显示出更好的生存率,这主要是由于肝功能的保留以及可能还预防了复发。术后IFN治疗似乎可降低HCV相关HCC消融治疗(如射频消融(RFA)治疗)后的复发率。我们认为使用IFN治疗进行二级预防有生存获益。然而,进行对照研究对于获得该策略疗效的确凿证据至关重要。

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