Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan.
Department of Gastroenterology and Hepatology, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama 336-8522, Japan.
Ann Hepatol. 2022 Mar-Apr;27(2):100660. doi: 10.1016/j.aohep.2022.100660. Epub 2022 Jan 8.
Continuous monitoring for hepatocellular carcinoma is necessary following treatment with direct-acting antivirals in patients with hepatitis C virus infection. We investigated whether the long-term follow-up of serum autotaxin levels could predict the development of hepatocellular carcinoma.
This prospective observational study enrolled adult patients with chronic hepatitis C virus infection who presented to the study center from January 2016 to March 2021. Among the patients who achieved a sustained viral response, the relationship between the development of hepatocellular carcinoma and serum autotaxin levels was assessed before treatment with direct-acting antivirals; at the end of therapy; at 12 and 24 weeks; and at 12, 24, 36, and 48 months after treatment.
Data were analyzed for 139 patients. Thirteen patients developed hepatocellular carcinoma 48 months after treatment. The cut-off serum autotaxin values that predicted hepatocellular carcinoma after 24 weeks were 1.22 (men) and 1.92 (women) mg/L. The area under the curve for serum autotaxin was 0.83 (95% confidence interval [CI]:0.71-0.95) in men and 0.90 (95% CI: 0.82-0.99) in women. The positive predictive value of serum autotaxin was 0.208 (95% CI: 0.139-0.248), and the negative predictive value was 0.971 (95% CI: 0.939-0.990). The cumulative incidence of hepatocellular carcinoma was significantly higher when serum autotaxin levels were above the cut-off value after 24 weeks (p < 0.0001).
Serum autotaxin is a candidate biomarker for predicting hepatocellular carcinoma during the long-term follow-up of patients with a sustained viral response following treatment with direct-acting antivirals.
在丙型肝炎病毒感染患者接受直接作用抗病毒药物治疗后，需要进行连续监测以预防肝细胞癌。我们研究了长期监测血清自分泌酶水平是否可预测肝细胞癌的发生。
这项前瞻性观察性研究纳入了 2016 年 1 月至 2021 年 3 月期间至研究中心就诊的慢性丙型肝炎病毒感染的成年患者。在获得持续病毒学应答的患者中，在接受直接作用抗病毒药物治疗前；治疗结束时；治疗后 12 周和 24 周；以及治疗后 12、24、36 和 48 个月时，评估了血清自分泌酶水平与肝细胞癌发展之间的关系。
对 139 例患者的数据进行了分析。13 例患者在治疗后 48 个月发生肝细胞癌。预测 24 周后肝细胞癌的血清自分泌酶截断值为男性 1.22（mg/L）和女性 1.92（mg/L）。男性血清自分泌酶的曲线下面积为 0.83（95%置信区间：0.71-0.95），女性为 0.90（95%置信区间：0.82-0.99）。血清自分泌酶的阳性预测值为 0.208（95%置信区间：0.139-0.248），阴性预测值为 0.971（95%置信区间：0.939-0.990）。在 24 周后血清自分泌酶水平超过截断值时，肝细胞癌的累积发生率明显更高（p<0.0001）。
血清自分泌酶是预测直接作用抗病毒药物治疗后持续病毒学应答患者长期随访期间肝细胞癌的候选生物标志物。
