Herrera Iván, Pascual Sonia, Zapater Pedro, Carnicer Fernando, Bellot Pablo, María Palazón José
aCIBERehd bLiver Unit, Gastroenterology Department cClinic Pharmacology Unit, Hospital General Universitario de Alicante dUniversity Miguel Hernández, Alicante, Spain.
Eur J Gastroenterol Hepatol. 2016 Oct;28(10):1194-7. doi: 10.1097/MEG.0000000000000677.
Patients with cirrhosis by hepatitis C virus infection treated with β-blockers (BB) have been shown to have a reduced incidence of hepatocellular carcinoma (HCC). Also, an association between propranolol therapy and lower incidence of other tumors has been described.
To analyze the incidence of HCC according to BB treatment in cirrhosis of any cause.
Cirrhotic patients included in the program for early detection of HCC were followed. Patients' data were prospectively registered, including transplantation and death. Patients were classified as chronically taken or not BB and the proportions of patients who remained free of tumor from the diagnosis of cirrhosis until the end of follow-up were compared using Kaplan-Meier analysis and the Breslow test.
A total of 173 patients (73 treated and 100 untreated BB) were followed. The median duration of follow-up was 11 years. There were no differences between both groups in the overall survival, number of deaths, or liver transplant.Overall, 28 patients developed HCC during the follow-up, 20 patients who were untreated and eight patients treated with BB. The cumulative proportion of cases of HCC between untreated and treated with BB from the diagnosis of cirrhosis was statistically significant (6 vs. 3%, at 5 years; 19 vs. 6% at 10 years; 24 vs. 16% at 15 years; P=0.048). Multivariate analyses showed BB intake as the only significant variable associated with the development of HCC.
Cirrhotic patients treated with BB have a lower cumulative probability of developing HCC during the 10 years after the diagnosis of cirrhosis.
丙型肝炎病毒感染所致肝硬化患者接受β受体阻滞剂（BB）治疗后，肝细胞癌（HCC）发病率降低。此外，还描述了普萘洛尔治疗与其他肿瘤较低发病率之间的关联。
分析在任何病因所致肝硬化中，根据BB治疗情况分析HCC的发病率。
对纳入HCC早期检测项目的肝硬化患者进行随访。前瞻性记录患者数据，包括移植和死亡情况。将患者分为长期服用或未服用BB组，采用Kaplan-Meier分析和Breslow检验比较从肝硬化诊断至随访结束时无肿瘤患者的比例。
共随访173例患者（73例接受BB治疗，100例未接受BB治疗）。中位随访时间为11年。两组在总生存率、死亡人数或肝移植方面无差异。总体而言，随访期间有28例患者发生HCC，20例未接受BB治疗，8例接受BB治疗。从肝硬化诊断起，未接受BB治疗组和接受BB治疗组HCC病例的累积比例在统计学上有显著差异（5年时分别为6%和3%；10年时分别为19%和6%；15年时分别为24%和16%；P = 0.048）。多因素分析显示服用BB是与HCC发生相关的唯一显著变量。
肝硬化诊断后10年内，接受BB治疗的肝硬化患者发生HCC的累积概率较低。
