Clin Gastroenterology H:肝细胞癌筛查与肝硬化患者的生存率增加有关

2019-04-07 不详 MedSci原创

目前指南推荐对肝硬化患者进行肝细胞癌(HCC)筛查,以增加早期肿瘤和生存的检测,但在临床实践中未得到充分利用,本项研究旨在探究这一方法的可操作性及有效性。

背景与目的
目前指南推荐对肝硬化患者进行肝细胞癌(HCC)筛查,以增加早期肿瘤和生存的检测,但在临床实践中未得到充分利用,本项研究旨在探究这一方法的可操作性及有效性。

方法
研究人员对2003年至2013年诊断为HCC的13714名患者进行了一项回顾性队列研究。研究人员使用多变量逻辑回归检验了筛查和肿瘤早期检测之间的关联。在调整了提前期偏差和长期时间偏差对生存率估计值的影响后,使用Cox比例风险模型评估了筛查接收与总体生存之间的关联。

结果
大多数肝硬化患者(51.1%)在确诊HCC前3年内未接受任何筛查,只有6.8%的患者接受了一致的年度筛查。具有一致筛选的比例从2003年的5.4%增加到2006年的2011年至2013年的8.8%(P<.001)。所覆盖时间的平均比例为13.4%,从2003年的11.7%增加到2006年的2013年至2013年的15.2%。一致性筛查的接收与早期肿瘤的检测相关(优势比,1.98; 95%CI, 1.68-2.33)并且在纠正提前期偏差后风险降低(风险比,0.76; 95%CI,0.70-0.83)。不一致的筛查与HCC早期检测的略微增加相关(优势比,1.31; 95%CI,1.20-1.43)和降低的死亡风险(风险比,0.86; 95%CI,0.83-0.90)。在纠正了铅和长时间偏倚后,一致(23%; 95%CI,21%-25%)和不一致筛查(19%; 95%CI,19%-20%)的患者比例更高与未筛查的患者相比,3年(13%; 95%CI,12%-14%)。

结论
本项研究发现HCC筛查对于肝硬化患者未得到充分利用,这一技术可以有助于肝癌患者在晚期阶段和更短的存活时间检测到肝脏肿瘤。

原始出处:

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    2019-05-27 xjy02
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    2020-02-19 许安
  6. [GetPortalCommentsPageByObjectIdResponse(id=2064678, encodeId=e0b920646e87b, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 18 19:04:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978836, encodeId=850019e8836bd, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Wed Oct 02 14:04:00 CST 2019, time=2019-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863431, encodeId=b474186343119, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon May 27 02:04:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711896, encodeId=eb6c1e1189627, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Jun 02 00:04:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072519, encodeId=15df20e25194f, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Feb 19 06:04:00 CST 2020, time=2020-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256702, encodeId=4e851256e02e6, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Tue Apr 09 04:04:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504643, encodeId=38b5150464336, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Apr 09 04:04:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046389, encodeId=09bc104638928, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Sun Apr 07 16:04:00 CST 2019, time=2019-04-07, status=1, ipAttribution=)]
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  8. [GetPortalCommentsPageByObjectIdResponse(id=2064678, encodeId=e0b920646e87b, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 18 19:04:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978836, encodeId=850019e8836bd, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Wed Oct 02 14:04:00 CST 2019, time=2019-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863431, encodeId=b474186343119, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon May 27 02:04:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711896, encodeId=eb6c1e1189627, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Jun 02 00:04:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072519, encodeId=15df20e25194f, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Feb 19 06:04:00 CST 2020, time=2020-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256702, encodeId=4e851256e02e6, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Tue Apr 09 04:04:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504643, encodeId=38b5150464336, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Apr 09 04:04:00 CST 2019, time=2019-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046389, encodeId=09bc104638928, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Sun Apr 07 16:04:00 CST 2019, time=2019-04-07, status=1, ipAttribution=)]
    2019-04-07 guging

    谢谢!最新的信息读起来就是收获大

    0

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在老年人(年龄65岁以上)中,发生急性胰腺炎最常见的原因是胆结石;然而,目前还比较缺乏评估急性胆源性胰腺炎(ABP)临床预后的结局的相关研究。因此,研究人员利用代表性人口数据库来评估老年人ABP的结局。

J Clin Gastro:他汀类药物可使急性胰腺炎严重程度降低

他汀类药物具有抗炎作用,对某些疾病具有保护作用;然而,它们对胰腺炎自然病史的影响尚不清楚。本研究的目的是使用倾向匹配方法评估他汀类药物的使用对胰腺炎严重程度和器官衰竭发生率的影响。

J Infect Dis: 通过呼气分析诊断人类棘球蚴病

人类棘球蚴病是一种被忽视的传染病,但它在全球影响着超过100万人。由于在这种病大都发生在资源贫乏地区,诊断费用昂贵且十分困难,因此如何快速有效诊断这种病是当务之急,本项研究旨在发明一种新型的诊断方法提高此病的诊断效率。