Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Gastroenterol. 2014 Apr;49(4):748-54. doi: 10.1007/s00535-013-0826-x. Epub 2013 May 22.
IL28B polymorphisms were shown to be associated with a response to peg-interferon-based treatment in chronic hepatitis C (CHC) and spontaneous clearance. However, little is known about how this polymorphism affects the course of CHC, including the development of hepatocellular carcinoma (HCC). We evaluated the influence of IL28B polymorphisms on hepatocarcinogenesis in CHC patients.
We genotyped the rs8099917 single-nucleotide polymorphism in 351 hepatitis C-associated HCC patients without history of IFN-based treatment, and correlated the age at onset of HCC in patients with each genotype.
Frequencies of TT, TG, and GG genotypes were 74.3 % (261/351), 24.8 % (87/351), and 0.9 % (3/351), respectively. The mean ages at onset of HCC for TT, TG, and GG genotypes were 69.9, 67.5 and 66.8, respectively. In multivariate analysis, IL28B minor allele (TG and GG genotypes) was an independent risk factor for younger age at onset of HCC (P = 0.02) in males (P < 0.001) with higher body mass index (BMI; P = 0.009). The IL28B minor allele was also associated with a lower probability of having aspartate aminotransferase-to-platelet ratio index (APRI) >1.5 (minor vs. major, 46.7 vs. 58.6 %; P = 0.01), lower AST (69.1 vs. 77.7 IU/L, P = 0.02), lower ALT (67.8 vs. 80.9 IU/L, P = 0.002), higher platelet count (12.8 vs. 11.2 × 10(4)/μL, P = 0.002), and higher prothrombin time (79.3 vs. 75.4 %, P = 0.002).
The IL28B minor allele was associated with lower inflammatory activity and less progressed fibrosis of the liver; however, it constituted a risk factor for younger-age onset of HCC in CHC patients.
白细胞介素 28B(IL28B)多态性与慢性丙型肝炎(CHC)患者对聚乙二醇干扰素治疗的反应和自发清除有关。然而,对于这种多态性如何影响 CHC 的病程,包括肝细胞癌(HCC)的发展,人们知之甚少。我们评估了 IL28B 多态性对 CHC 患者肝癌发生的影响。
我们对 351 例无干扰素治疗史的丙型肝炎相关 HCC 患者的 rs8099917 单核苷酸多态性进行了基因分型,并将每位患者的 HCC 发病年龄与各基因型相关联。
TT、TG 和 GG 基因型的频率分别为 74.3%(261/351)、24.8%(87/351)和 0.9%(3/351)。TT、TG 和 GG 基因型的 HCC 发病年龄分别为 69.9、67.5 和 66.8 岁。多变量分析显示,IL28B 次要等位基因(TG 和 GG 基因型)是男性(P<0.001)、高体重指数(BMI;P=0.009)的 HCC 发病年龄较小的独立危险因素。IL28B 次要等位基因也与天门冬氨酸氨基转移酶与血小板比值指数(APRI)>1.5 的可能性较低有关(次要等位基因 vs. 主要等位基因,46.7% vs. 58.6%;P=0.01),AST 较低(69.1 vs. 77.7 IU/L,P=0.02),ALT 较低(67.8 vs. 80.9 IU/L,P=0.002),血小板计数较高(12.8 vs. 11.2×10^4/μL,P=0.002),凝血酶原时间较高(79.3 vs. 75.4%,P=0.002)。
IL28B 次要等位基因与较低的炎症活性和肝脏进展性纤维化有关;然而,它构成了 CHC 患者 HCC 发病年龄较小的危险因素。