Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Front Cell Infect Microbiol. 2023 Jan 13;12:1104399. doi: 10.3389/fcimb.2022.1104399. eCollection 2022.
Probiotics may offer cancer-prevention benefits, based on experimental investigation results. This study aimed to determine the potential association between probiotics and hepatocellular carcinoma (HCC) in patients with hepatitis B-related cirrhosis (HBC) receiving antiviral therapy.
This retrospective study included 1267 patients with HBC treated with entecavir or tenofovir between January 2013 and December 2017. The risk of developing HCC was compared between two cohorts of 449 probiotic users (taking a cumulative defined daily doses [cDDD] of ≥ 28) and 818 non-probiotic users (< 28 cDDD). To eliminate the bias caused by confounding factors, propensity score matching (PSM) was used.
On multivariate regression analysis, probiotic consumption was an independent protective factor for HCC occurrence. After PSM, the incidence of HCC was significantly lower in the probiotic users than that in the nonusers (adjusted hazard ratio [aHR]: 0.70, 95% confidence interval: 0.59-0.83, < 0.001). The aHRs for probiotics with 28-89, 90-180, and >180 cDDD were 0.58, 0.28, and 0.12, respectively, indicating a dose-response pattern. In 28-89, 90-180, and >180 cDDD, the 3-year cumulative incidence of HCC was 8.7%, 4.7%, and 3.0%, respectively. A multivariate stratified analysis confirmed that the administration of probiotics could help patients.
Adjuvant probiotic therapy may reduce the risk of HCC in patients receiving antiviral medication for HBC. However, further clinical research is required to confirm these findings.
基于实验研究结果，益生菌可能具有预防癌症的作用。本研究旨在确定接受抗病毒治疗的乙型肝炎相关肝硬化（HBC）患者中益生菌与肝细胞癌（HCC）之间的潜在关联。
本回顾性研究纳入了 2013 年 1 月至 2017 年 12 月期间接受恩替卡韦或替诺福韦治疗的 1267 例 HBC 患者。比较了两组患者的 HCC 发病风险，一组为 449 例益生菌使用者（累积定义日剂量[ cDDD ]≥28），另一组为 818 例非益生菌使用者（ cDDD <28）。为了消除混杂因素引起的偏倚，采用了倾向评分匹配（PSM）。
多变量回归分析显示，益生菌的使用是 HCC 发生的独立保护因素。PSM 后，益生菌使用者的 HCC 发生率明显低于非使用者（调整后的危险比[aHR]：0.70，95%置信区间：0.59-0.83， <0.001）。28-89、90-180 和>180 cDDD 的益生菌 aHR 分别为 0.58、0.28 和 0.12，呈剂量反应模式。在 28-89、90-180 和>180 cDDD 时，HCC 的 3 年累积发生率分别为 8.7%、4.7%和 3.0%。多变量分层分析证实了益生菌的使用可以帮助患者。
辅助益生菌治疗可能降低接受抗病毒药物治疗的 HBC 患者 HCC 的风险。然而，需要进一步的临床研究来证实这些发现。
