Yu Jung Hwan, Jin Young-Joo, Lee Jin-Woo, Lee Don-Haeng
Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea.
The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, South Korea.
Hepatol Res. 2018 Oct;48(11):862-871. doi: 10.1111/hepr.13194. Epub 2018 Jun 4.
We aimed to identify the incidence rate of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients treated with entecavir or tenofovir in South Korea, and to identify predictors of HCC development in these patients.
Between January 2007 and December 2015, 582 CHB patients initially received entecavir (n = 406, 69.8%) or tenofovir (n = 176, 30.2%) for CHB.
During a median follow-up of 57.1 months, HCC developed in 38 (6.5%) of the 582 patients, regardless of antiviral agent type. Entecavir- and tenofovir-treated patients had similar HCC development rates (P = 0.471). For the 582 patients, 2-, 4-, and 6-year cumulative HCC development rates were 2.6%, 4.4%, and 8.3%, respectively, and the 2-, 4-, and 6-year cumulative HCC development rates of patients with liver cirrhosis were significantly greater than those of patients without liver cirrhosis (6.2%, 9.8%, and 18.4% vs. 0.3%, 1.1%, and 2.2%, respectively; P < 0.001). Older (≥60 years) patients, regardless of the presence of cirrhosis, and cirrhotic patients aged ≥40 years showed significantly higher risk of HCC development compared to others (both P < 0.05). Multivariate analysis showed that an older age (≥50 years; hazard ratio [HR] 5.02, P = 0.009), and the presence of cirrhosis (HR 4.95, P = 0.002) independently predicted HCC development.
The 6-year cumulative HCC development rate was 6.5% in CHB patients treated with entecavir or tenofovir. Age ≥50 years and liver cirrhosis were found to predict HCC development in these patients.
我们旨在确定在韩国接受恩替卡韦或替诺福韦治疗的慢性乙型肝炎（CHB）患者中肝细胞癌（HCC）的发病率，并确定这些患者中HCC发生的预测因素。
2007年1月至2015年12月期间，582例CHB患者最初接受恩替卡韦（n = 406，69.8%）或替诺福韦（n = 176，30.2%）治疗CHB。
在中位随访57.1个月期间，582例患者中有38例（6.5%）发生了HCC，与抗病毒药物类型无关。接受恩替卡韦和替诺福韦治疗的患者HCC发生率相似（P = 0.471）。对于这582例患者，2年、4年和6年累积HCC发生率分别为2.6%、4.4%和8.3%，肝硬化患者的2年、4年和6年累积HCC发生率显著高于无肝硬化患者（分别为6.2%、9.8%和18.4% vs. 0.3%、1.1%和2.2%；P < 0.001）。年龄较大（≥60岁）的患者，无论是否有肝硬化，以及年龄≥40岁的肝硬化患者发生HCC的风险均显著高于其他患者（均P < 0.05）。多因素分析显示，年龄较大（≥50岁；风险比[HR] 5.02，P = 0.009）和存在肝硬化（HR 4.95，P = 0.002）可独立预测HCC的发生。
接受恩替卡韦或替诺福韦治疗的CHB患者6年累积HCC发生率为6.5%。发现年龄≥50岁和肝硬化可预测这些患者中HCC的发生。
