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替诺福韦可降低慢性乙型肝炎患者肝切除术后肝细胞癌的复发率。

Tenofovir decrease hepatocellular carcinoma recurrence in chronic hepatitis B patients after liver resection.

作者信息

Zhang Min, Wang Dexin, Liu Haidong, Li Hui

机构信息

Department of Gastroenterology, Qingdao NO.6 People's Hospital, Qingdao, Shandong 266033 People's Republic of China.

10th Department of Hepatology, Qingdao NO.6 People's Hospital, Qingdao, Shandong 266033 People's Republic of China.

出版信息

Infect Agent Cancer. 2018 Jun 8;13:19. doi: 10.1186/s13027-018-0191-8. eCollection 2018.

Abstract

BACKGROUND

Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are recommended as the first-line choices regarding the treatment of chronic hepatits B. The impact of the two antiviral agents on prognosis of Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored. We aim to investigate whether CHB-related HCC patients receiving TDF and ETV have a different prognosis.

METHODS

233 CHB-related compensated cirrhosis patients were divided into groups according to the nucleut(s)ide patients received. The results of TDF and ETV groups were reviewed and compared. The disease-free survival (DFS) and overall survival (OS) of both groups were analyzed and compared.

RESULTS

233 CHB-related compensated cirrhosis patients from 2013 October to 2014 November were included in our study. 107 and 126 patients received TDF and ETV monotherapy, respectively. Child-Pugh score, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin level, status of hepatitis B e antigen (HBeAg) and serum HBV DNA level were compared between groups. DFS in TDF-treatment group were significantly longer than it in ETV-treatment group ( < 0.05). multi-variant analysis indicated that TDF duration was significantly associated with lower probability of HCC development, (hazard ratio, 0.35; 95% confidence interval range, 0.33-0.84,  < 0.05).

CONCLUSION

Anti-virus regimen containing TDF benefits for the prognosis of CHB-related liver cirrhosis patients.

摘要

背景

富马酸替诺福韦二吡呋酯(TDF)和恩替卡韦(ETV)被推荐作为慢性乙型肝炎治疗的一线选择。这两种抗病毒药物对慢性乙型肝炎(CHB)相关肝细胞癌(HCC)预后的影响仍有待探索。我们旨在研究接受TDF和ETV治疗的CHB相关HCC患者是否有不同的预后。

方法

233例CHB相关代偿期肝硬化患者根据其接受的核苷(酸)类药物分组。回顾并比较TDF组和ETV组的结果。分析并比较两组的无病生存期(DFS)和总生存期(OS)。

结果

我们的研究纳入了2013年10月至2014年11月期间的233例CHB相关代偿期肝硬化患者。分别有107例和126例患者接受TDF和ETV单药治疗。比较了两组之间的Child-Pugh评分、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素水平、乙肝e抗原(HBeAg)状态和血清HBV DNA水平。TDF治疗组的DFS明显长于ETV治疗组(<0.05)。多变量分析表明,TDF治疗时间与HCC发生概率降低显著相关(风险比,0.35;95%置信区间范围,0.33-0.84,<0.05)。

结论

含TDF的抗病毒方案对CHB相关肝硬化患者的预后有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9445/5994044/f2c8e0cd0cf2/13027_2018_191_Fig1_HTML.jpg

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