Umehara Yasuko, Hagiwara Satoru, Nishida Naoshi, Sakurai Toshiharu, Ida Hiroshi, Minami Yasunori, Takita Masahiro, Minami Tomohiro, Chishina Hirokazu, Ueshima Kazuomi, Komeda Yoriaki, Arizumi Tadaaki, Watanabe Tomohiro, Kudo Masatoshi
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Dig Dis. 2017;35(6):548-555. doi: 10.1159/000480147. Epub 2017 Oct 17.
It is a generally accepted fact that eradication of hepatitis virus C inhibits the subsequent development of hepatocellular carcinoma (HCC). On the contrary, a significant population of patients developed HCC despite sustained virological responses (SVRs) to interferon (IFN) therapy.
A total of 415 patients with chronic hepatitis C, who were treated at our hospital between 2004 and 2014, were enrolled for this study. We examined the risk factors for HCC development after IFN therapy.
After analyzing various clinical parameters, it was concluded that a serum albumin (ALB) level <4.0 g/dL and the presence or absence of SVR achievement were risk factors for the development of HCC. When analyzing pre- and posttreatment factors, only a serum ALB level <4.0 g/dL was considered a significant risk factor. The presence or absence of liver fibrosis progression was not identified as a risk factor.
In patients with a serum ALB level <4.0 g/dL before IFN therapy, hepatic carcinogenesis after SVR achievement need to be considered. Furthermore, the serum ALB level may be more useful than the degree of fibrosis for the prediction of HCC after SVR in chronic hepatitis C.
丙型肝炎病毒的清除可抑制随后肝细胞癌(HCC)的发生,这是一个普遍公认的事实。相反,相当一部分患者尽管对干扰素(IFN)治疗获得了持续病毒学应答(SVR),仍发生了HCC。
本研究纳入了2004年至2014年在我院接受治疗的415例慢性丙型肝炎患者。我们研究了IFN治疗后HCC发生的危险因素。
在分析了各种临床参数后,得出血清白蛋白(ALB)水平<4.0 g/dL以及是否获得SVR是HCC发生的危险因素。在分析治疗前和治疗后因素时,仅血清ALB水平<4.0 g/dL被认为是一个显著的危险因素。肝纤维化进展与否未被确定为危险因素。
对于IFN治疗前血清ALB水平<4.0 g/dL的患者,在获得SVR后需要考虑肝癌发生的可能性。此外,血清ALB水平在预测慢性丙型肝炎患者SVR后的HCC方面可能比纤维化程度更有用。