Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gut Liver. 2007 Jun;1(1):49-55. doi: 10.5009/gnl.2007.1.1.49. Epub 2007 Jun 30.
BACKGROUND/AIMS: The authors examined whether the response to interferon (IFN) therapy can affect the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients.
Out of 353 biopsy-proven CHB patients, 229 (65%) were treated with IFN-alpha for 6 to 12 months. They were followed for a median period of 75 months (range, 6-120). In patients treated with IFN, biochemical and virologic responses were evaluated at the end of treatment (EOT). The cumulative incidence rates of HCC were calculated and analyzed in relation to baseline characteristics as well as biochemical and virologic responses to IFN therapy.
The overall cumulative incidence of HCC was 0%, 0.8%, 3.7% and 5.5% at 3, 5, 7 and 8 years, respectively. Age, serum AFP levels and the stage of fibrosis were significantly associated with the occurrence of HCC. As a whole, IFN therapy did not affect the occurrence of HCC. Among the patients treated with IFN, biochemical responders had low HCC incidence rates compared with non-responders (p=0.018). However, the HCC incidence rates of virologic responders were not different from non-responders (p=0.203).
Biochemical rather than virologic response to IFN therapy may be more closely associated with decrease of HCC incidence in CHB patients.
背景/目的：作者研究了干扰素（IFN）治疗的应答是否会影响慢性乙型肝炎（CHB）患者发生肝细胞癌（HCC）。
353 例经活检证实的 CHB 患者中，有 229 例（65%）接受 IFN-α治疗 6-12 个月。中位随访时间为 75 个月（范围 6-120 个月）。在接受 IFN 治疗的患者中，在治疗结束时（EOT）评估了生化和病毒学应答。根据基线特征以及对 IFN 治疗的生化和病毒学应答，计算并分析 HCC 的累积发生率。
总体而言，HCC 的累积发生率分别为 0%、0.8%、3.7%和 5.5%，在 3、5、7 和 8 年时。年龄、血清 AFP 水平和纤维化分期与 HCC 的发生显著相关。整体而言，IFN 治疗并未影响 HCC 的发生。在接受 IFN 治疗的患者中，生化应答者 HCC 的发生率低于无应答者（p=0.018）。但是，病毒学应答者的 HCC 发生率与无应答者没有差异（p=0.203）。
IFN 治疗的生化应答而非病毒学应答可能与 CHB 患者 HCC 发生率的降低更密切相关。
