直接抗病毒药物清除丙型肝炎病毒后细胞因子变化对肝细胞癌风险的影响。
The impact of cytokine change after hepatitis C virus clearance by direct antiviral agents on the risk of hepatocellular carcinoma.
机构信息
Department of Gastroenterology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Gastroenterology, Da-Lin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
出版信息
J Formos Med Assoc. 2021 Mar;120(3):965-973. doi: 10.1016/j.jfma.2020.10.015. Epub 2020 Oct 29.
BACKGROUND/PURPOSE: De novo and early recurrent hepatocellular carcinoma (HCC) have been observed in clinical practice after direct antiviral agents (DAA) treatment. The study aims to investigate the change of cytokines and growth factors after hepatitis C virus (HCV) clearance by DAAs and their impact on the risk of HCC development.
METHODS
The chronic hepatitis C (CHC) patients with or without HCC who received DAA treatment were prospectively enrolled. The cytokines and growth factors were measured using Bio-Plex Pro™ Human Cytokine 27-plex Assay before and 12 weeks off DAA treatment.
RESULTS
A total of 37 patients were enrolled for final analysis. There were 11 males (29.7%) and 26 females (70.3%). The mean age was 67.39 ± 10.48 years. 11 (29.7%) patients were HCV-related HCC patients. The HCV genotype included genotype 2 in 26 patients and genotype 1b in 10 patients, and genotype 6 in 1. Among them, 35 (94.6%) patients achieved sustained virologic response (SVR). Two patients with HCC failed to DAA treatment. In HCV-related HCC patients, serum IP-10 level significantly declined after HCV clearance, but no difference in five growth factors including G-CSF, GM-CSF, basic FGF, PDGF-BB, and VEGF. Several cytokines including IP-10 significantly declined after HCV clearance in CHC patients.
CONCLUSION
This study showed only serum IP-10 level, a risk factor of HCC, was significantly declined after HCV clearance and no change in the markers of growth factors in HCV-related HCC patients, suggesting no promotion of HCC using DAA treatment for HCV-related HCC patients.
背景/目的：在直接抗病毒药物（DAA）治疗后，临床上观察到新发和早期复发性肝细胞癌（HCC）。本研究旨在探讨 DAA 清除 HCV 后细胞因子和生长因子的变化及其对 HCC 发展风险的影响。
方法
前瞻性纳入接受 DAA 治疗的有或无 HCC 的慢性丙型肝炎（CHC）患者。在 DAA 治疗前和停药后 12 周，使用 Bio-Plex Pro™ 人类细胞因子 27 plex 检测试剂盒检测细胞因子和生长因子。
结果
共纳入 37 例患者进行最终分析。其中男性 11 例（29.7%），女性 26 例（70.3%）。平均年龄为 67.39±10.48 岁。11 例（29.7%）为 HCV 相关 HCC 患者。HCV 基因型包括 26 例 2 型和 10 例 1b 型，1 例 6 型。其中 35 例（94.6%）患者达到持续病毒学应答（SVR）。2 例 HCC 患者 DAA 治疗失败。在 HCV 相关 HCC 患者中，HCV 清除后血清 IP-10 水平显著下降，但 G-CSF、GM-CSF、碱性 FGF、PDGF-BB 和 VEGF 等 5 种生长因子无差异。CHC 患者 HCV 清除后，包括 IP-10 在内的几种细胞因子显著下降。
结论
本研究表明，仅血清 IP-10 水平，即 HCC 的一个危险因素，在 HCV 清除后显著下降，而在 HCV 相关 HCC 患者中，生长因子的标志物无变化，提示 DAA 治疗 HCV 相关 HCC 患者不会促进 HCC 的发生。
Zotero 插件