Ansari Shahla, Azarkivan Azita, Halagi Farideh
Department of Hematology & Oncnlogy, Ali Asghar Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Jul 13;51(6):404-7.
Hepatitis is the infections of a common cause disease among poly transfused patients. Hepatitis C is slowed progression and inducing HCC. This study assessed HCC incidences, the role of iron and possible antitumor activity of chelators in 170 thalassemia patients using deferoxamine (DFO) therapy. They are diagnosed with Hepatitis C due to positive PCR-RNA. They are Treated with IFN. The follow up program including tests every 3 Months and PCR-RNA, AFP and liver US every 6 months. Whenever there was suspicion of liver malignancy, Biopsy was performed. From the total of 170 patients, 59.4% were male, and 40.6% were female. Mean age of thalassemia diagnosis was 2.69±5.403 (1-41) years and mean Age of hepatitis diagnosis was 17.37±7.263 (3-51) years. 92.4 % of Patient's MT, 0.6 % SS, 2.9% TI. the viral genome was 1a3a. 73.5% of patients had first course of therapy. The frequency of AFP greater than 10 was 5.9%. And the incidence of HCC was 0.6 %(1/170) with a 95% confidence interval. The main risk factor for HCC was HCV infection in TM patients, but it was iron activity in TI patients. Iron chelation with DFO appeared to play a Protective role.
肝炎是多次输血患者中常见的感染性病因疾病。丙型肝炎进展缓慢并会诱发肝癌。本研究评估了170例使用去铁胺（DFO）治疗的地中海贫血患者的肝癌发病率、铁的作用以及螯合剂可能的抗肿瘤活性。他们因PCR-RNA呈阳性而被诊断为丙型肝炎。他们接受了干扰素治疗。随访计划包括每3个月进行一次检查，每6个月进行一次PCR-RNA、甲胎蛋白（AFP）和肝脏超声检查。每当怀疑有肝脏恶性肿瘤时，就进行活检。在总共170例患者中，59.4%为男性，40.6%为女性。地中海贫血诊断的平均年龄为2.69±5.403（1 - 41）岁，肝炎诊断的平均年龄为17.37±7.263（3 - 51）岁。92.4%的患者为MT型，0.6%为SS型，2.9%为TI型。病毒基因组为1a3a。73.5%的患者接受了第一个疗程的治疗。AFP大于10的频率为5.9%。肝癌的发病率为0.6%（1/170），95%置信区间。TM患者中肝癌的主要危险因素是HCV感染，但TI患者中是铁活性。用DFO进行铁螯合似乎起到了保护作用。
