Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Dig Dis Sci. 2012 Apr;57(4):1092-101. doi: 10.1007/s10620-011-1934-1. Epub 2011 Oct 12.
Treatment of chronic hepatitis C virus (HCV) infection with interferon (IFN) prevents the development of hepatocellular carcinoma (HCC). The purpose of this study was to clarify the effect of previous IFN treatment before the development of HCC on recurrence and survival in HCV-related HCC patients.
Three hundred ninety-five patients who underwent curative treatment for HCV-related HCC were enrolled. Of these, 124 had received IFN treatment before the development of HCC (17 achieved sustained virological response [SVR group] and 107 did not [non-SVR group]), whereas 271 patients had never received IFN treatment (IFN-untreated group). The first and second recurrence and survival rates in these patient groups were statistically analyzed.
The first HCC recurrence rate was similar among patient groups. In contrast, the second HCC recurrence rate was significantly lower in the SVR group than in the non-SVR group (p = 0.003) and the IFN-untreated group (p = 0.006). In multivariate analysis, platelet count (p = 0.033) and number of tumors (p = 0.001) were associated with the first HCC recurrence, while SVR (p = 0.002) was the only factor associated with the second HCC recurrence. The survival rate was higher in the SVR group than in non-SVR and IFN-untreated groups, and SVR to previous IFN treatment was an independent factor associated with better survival (p < 0.001).
SVR to previous IFN treatment before the development of HCV-related HCC was associated with lower risk of the second recurrence of HCC and better survival.
用干扰素(IFN)治疗慢性丙型肝炎病毒(HCV)感染可预防肝细胞癌(HCC)的发生。本研究旨在阐明在 HCC 发生前接受 IFN 治疗对 HCV 相关 HCC 患者复发和生存的影响。
共纳入 395 例接受 HCV 相关 HCC 根治性治疗的患者。其中 124 例在 HCC 发生前接受过 IFN 治疗(17 例获得持续病毒学应答[SVR]组和 107 例未获得[SVR]组),271 例从未接受过 IFN 治疗(IFN 未治疗组)。对这些患者组的首次和第二次复发及生存率进行了统计学分析。
各组患者的首次 HCC 复发率相似。相反,SVR 组的第二次 HCC 复发率明显低于非 SVR 组(p = 0.003)和 IFN 未治疗组(p = 0.006)。多因素分析显示,血小板计数(p = 0.033)和肿瘤数量(p = 0.001)与首次 HCC 复发相关,而 SVR(p = 0.002)是与第二次 HCC 复发相关的唯一因素。SVR 组的生存率高于非 SVR 组和 IFN 未治疗组,且对既往 IFN 治疗的 SVR 是与生存改善相关的独立因素(p < 0.001)。
在发生 HCV 相关 HCC 之前对 IFN 治疗获得 SVR 与 HCC 第二次复发风险降低和生存改善相关。