Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung Dist. 833, Kaohsiung, Taiwan.
Department of Biological Sciences, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung 80424, Taiwan.
J Formos Med Assoc. 2018 Sep;117(9):833-840. doi: 10.1016/j.jfma.2017.10.003. Epub 2017 Oct 28.
BACKGROUND/PURPOSE: Prdevious meta-analyses assess whether or not patatin-like phospholipase domain containing 3 (PNPLA3) (rs738409 C > G) was associated with increased risk of hepatocellular carcinoma (HCC) in Caucasians patients with hepatitis C virus (HCV)-related cirrhosis, these meta-analyses did not provide firm conclusions. Only one cross-sectional study involving Asian patients has previously been conducted to explore this issue. We aim to investigate this in a longitudinal cohort of Asian chronic hepatitis C (CHC) patients.
We consecutively enrolled 1011 CHC patients who underwent liver biopsy before initiating interferon-based therapy. These patients were followed-up and screened for HCC up to a median of 6.9 years. The influence of rs738409 (GG) genotype on the occurrence of HCC was assessed using the Kaplan-Meier method, then according to the multivariate Cox model.
During follow-up, 143 (14.1%) patients developed HCC. rs738409 (GG) genotype was not associated with time-to-HCC development on multivariate Cox regression (P = 0.634). When considering the occurrence of these events over time, rs738409 (GG) genotype did not influence the risk of HCC development (log-rank = 0.12). Among 261 patients with liver cirrhosis, rs738409 (GG) genotype was not associated with time-to-HCC development on multivariate Cox regression (P = 0.737). When considering the occurrence of these events over time, rs738409 (GG) genotype did not influence the risk of HCC development (log-rank = 0.72).
In this longitudinal study with liver biopsy to stage liver fibrosis, we affirm there is no influence of the rs738409 (GG) genotype on the occurrence of HCC in Asian CHC patients, including cirrhotic patients.
背景/目的：先前的荟萃分析评估了 patatin 样磷脂酶结构域包含 3（PNPLA3）（rs738409 C > G）是否与丙型肝炎病毒（HCV）相关肝硬化的白人患者肝细胞癌（HCC）风险增加相关，但这些荟萃分析没有得出明确的结论。先前只有一项涉及亚洲患者的横断面研究探讨了这个问题。我们旨在对亚洲慢性丙型肝炎（CHC）患者的纵向队列中进行这项研究。
我们连续纳入了 1011 名在开始基于干扰素治疗前接受肝活检的 CHC 患者。这些患者接受了随访，并在中位时间为 6.9 年的时间内筛查 HCC。使用 Kaplan-Meier 方法评估 rs738409（GG）基因型对 HCC 发生的影响，然后根据多变量 Cox 模型进行评估。
在随访期间，143 名（14.1%）患者发生 HCC。多变量 Cox 回归分析显示 rs738409（GG）基因型与 HCC 发生时间无关（P=0.634）。当考虑随着时间的推移这些事件的发生时，rs738409（GG）基因型并不影响 HCC 发生的风险（对数秩检验=0.12）。在 261 名肝硬化患者中，多变量 Cox 回归分析显示 rs738409（GG）基因型与 HCC 发生时间无关（P=0.737）。当考虑随着时间的推移这些事件的发生时，rs738409（GG）基因型并不影响 HCC 发生的风险（对数秩检验=0.72）。
在这项具有肝活检以分期纤维化的纵向研究中，我们确认 rs738409（GG）基因型对亚洲 CHC 患者（包括肝硬化患者）的 HCC 发生没有影响。
