Sata M, Ide T, Akiyoshi F, Fukuizumi K, Noguchi S, Shirachi M, Sasaki M, Uchimura Y, Suzuki H, Tanikawa K
Department of Medicine, Kurume University School of Medicine, Japan.
Kurume Med J. 1997;44(3):171-7. doi: 10.2739/kurumemedj.44.171.
To determine the incidence of hepatocellular carcinoma among patients with chronic hepatitis C who received interferon (IFN) therapy, 63 patients with chronic hepatitis C who underwent IFN therapy (IFN alpha 2a 9 x 10(6) IU daily for 2 weeks and followed 9 x 10(6) IU three times weekly for 14 weeks) from January to December 1992, were studied. Selection criteria were as follows: within six months before IFN therapy patients were diagnosed with chronic active hepatitis without cirrhosis by hepatic histological examination, and were hepatitis C virus antibody positive. Furthermore, patients had records of follow-up liver function tests (once a month) for more than six months after IFN therapy completion, and of ultrasound scanning (once in three to four months) before and for at least more than six months after the therapy completion. An average period of observation was 2.7 years (0.6 to 3.8 years). Twenty five of 63 patients (39.7%) returned to normal values of serum ALT, whereas 38 of 63 (60.3%) still showed abnormal values at six months after IFN therapy completion. Nine of 63 (14.2%) and 6/63 (9.5%) developed cirrhosis and hepatocellular carcinoma, respectively. All patients who developed cirrhosis and hepatocellular carcinoma were from those (n = 38) that showed abnormal ALT values after therapy completion. The five of six patients that progressed to hepatocellular carcinoma were associated with cirrhosis. No patients who returned to normal ALT values developed hepatocellular carcinoma during the period of observation. These results suggest that IFN therapy is effective to prevent the development of hepatocellular carcinoma.
为确定接受干扰素(IFN)治疗的慢性丙型肝炎患者中肝细胞癌的发病率,我们对1992年1月至12月期间接受IFN治疗(IFNα2a,每日9×10⁶IU,共2周,随后每周3次,每次9×10⁶IU,共14周)的63例慢性丙型肝炎患者进行了研究。选择标准如下:IFN治疗前6个月内,经肝脏组织学检查确诊为无肝硬化的慢性活动性肝炎,且丙型肝炎病毒抗体阳性。此外,患者在IFN治疗结束后有超过6个月的每月一次肝功能检查记录,以及治疗前和治疗结束后至少6个月以上每3至4个月一次的超声扫描记录。平均观察期为2.7年(0.6至3.8年)。63例患者中有25例(39.7%)血清ALT恢复正常,而63例中有38例(60.3%)在IFN治疗结束6个月时仍显示异常值。63例中有9例(14.2%)和6/63(9.5%)分别发展为肝硬化和肝细胞癌。所有发展为肝硬化和肝细胞癌的患者均来自治疗结束后ALT值异常的患者(n = 38)。进展为肝细胞癌的6例患者中有5例与肝硬化有关。在观察期内,ALT恢复正常的患者均未发生肝细胞癌。这些结果表明,IFN治疗对预防肝细胞癌的发生有效。