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系统评价:基于干扰素的治疗对丙型肝炎病毒相关肝细胞癌的影响

Systematic Review: Impact of Interferon-based Therapy on HCV-related Hepatocellular Carcinoma.

作者信息

Hsu Ching-Sheng, Chao You-Chen, Lin Hans Hsienhong, Chen Ding-Shinn, Kao Jia-Horng

机构信息

Division of Gastroenterology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.

School of Medicine, Tzu Chi University, Hualien, Taiwan.

出版信息

Sci Rep. 2015 May 12;5:9954. doi: 10.1038/srep09954.

Abstract

Hepatitis C virus (HCV) is the leading cause of hepatocellular carcinoma (HCC), and several antiviral agents are available for the treatment of chronic HCV infection. However, the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients remains inconclusive. We aimed to examine the impact of antiviral therapy on the long-term outcomes of HCV-related HCC patients. We conducted a systematic review using PRISMA guidelines to identify trials and English-language literature from PubMed, Ovid MEDLINE, Scopus and the Cochrane Library database till August 2014. Randomized trials of antiviral treatments examining the effects of antiviral therapy on CHC patients and HCV-related HCC patients were screened and selected. We identified 6 trials evaluated the effectiveness of interferon (IFN)-alfa treatment, 3 studies examined pegylated interferon-alfa treatment, and 2 studies examined IFN-beta treatment. IFN-based therapy may decrease HCC incidence in HCV cirrhotic patients after a >5-year follow-up, improve liver reserve, decrease HCC recurrence rate, and increase survival rate in HCV-related HCC patients after curative HCC therapy. In conclusion, IFN-based therapy is beneficial and may be recommended in the management of HCV-related HCC patients who are IFN eligible.

摘要

丙型肝炎病毒(HCV)是肝细胞癌(HCC)的主要病因,目前有几种抗病毒药物可用于治疗慢性HCV感染。然而,抗病毒治疗对HCV相关HCC患者长期预后的影响仍不明确。我们旨在研究抗病毒治疗对HCV相关HCC患者长期预后的影响。我们使用PRISMA指南进行了一项系统评价,以识别截至2014年8月来自PubMed、Ovid MEDLINE、Scopus和Cochrane图书馆数据库的试验和英文文献。筛选并选取了研究抗病毒治疗对CHC患者和HCV相关HCC患者影响的抗病毒治疗随机试验。我们确定了6项评估干扰素(IFN)-α治疗有效性的试验、3项研究聚乙二醇化干扰素-α治疗的研究以及2项研究IFN-β治疗的研究。基于IFN的治疗可能会在超过5年的随访后降低HCV肝硬化患者的HCC发病率,改善肝脏储备功能,降低HCV相关HCC患者在根治性HCC治疗后的HCC复发率,并提高生存率。总之,基于IFN的治疗是有益的,对于符合IFN治疗条件的HCV相关HCC患者,在管理中可能推荐使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08f/4428066/fd5585bf4135/srep09954-f1.jpg

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