Clin Gastroenterology H: 因HFE突变引起的血色素沉着病患者行抗纤维化治疗后可降低肝癌发生风险

2020-08-07 MedSci原创 MedSci原创

存在稳态铁调节基因(HFE)突变引起的血色素沉着病患者肝纤维化的几率会大大增加,本项研究旨在评估此类患者经过抗纤维化治疗后肝癌的发生风险是否能降低。

背景与目标

存在稳态铁调节基因(HFE)突变引起的血色素沉着病患者肝纤维化的几率会大大增加,本项研究旨在评估此类患者经过抗纤维化治疗后肝癌的发生风险是否能降低。

方法

研究人员对法国及澳大利亚的106例HFE中C282Y突变纯合为F3纤维化(n = 40)或F4纤维化(n = 66)的患者进行了回顾性分析,并从中至少进行了一次肝活检。首次和最后一次肝活检之间的中位时间为9.5年(范围3.5-15.6年)。同时研究人员收集了肝功能,铁存储标记和血小板水平的测试结果。

 

结果

在最后一次肝活检中,有41名患者(38.6%)的纤维化评分为F2或更低。最后一次肝活检时有34例F3或F4纤维化患者发生肝癌(52.3%),而最近一次肝活检的F2或更少的为2例患者(4.8%)(P <.001)。F3或F4纤维化患者的肝癌发病率是每千人年32.8(95%CI,每千人年22.​​7–45.9)和每千人年2.3(95%CI,每千人年0.2–8.6年)。在多变量分析中,男性(危险比[HR],6.09; 95%CI,1.21-30.4),诊断时年龄(HR,1.16; 95%CI,1.09-1.25),存在糖尿病(HR,3.07; 95) %CI,1.35-6.97),过量饮酒(HR,3.1; 95%CI,1.47-6.35)都是肝癌发生的独立危险因素。

 

结论

在对由HFE中的C282Y突变引起的血色素沉着病患者进行的回顾性分析中,研究人员发现严重的肝纤维化可以通过治疗而消退。在纤维化消退至F2或以下的患者中,肝癌的长期风险显着降低。

原始出处:

Edouard Bardou-Jacquet. Et al. Regression of Fibrosis Stage With Treatment Reduces Long-Term Risk of Liver Cancer in Patients With Hemochromatosis Caused by Mutation in HFE. Clin Gastroenterology H.2020.

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    2021-07-20 sunylz
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505053, encodeId=f2921505053a5, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, 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=Sat Aug 08 01:19:31 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040309, encodeId=f4871040309a4, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Thu Aug 06 13:19:31 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505053, encodeId=f2921505053a5, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, 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=Sat Aug 08 01:19:31 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040309, encodeId=f4871040309a4, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Thu Aug 06 13:19:31 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1812610, encodeId=b8ce1812610d5, content=<a href='/topic/show?id=04978995099' target=_blank style='color:#2F92EE;'>#血色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89950, encryptionId=04978995099, topicName=血色素)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu Dec 17 11:19:31 CST 2020, time=2020-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680682, encodeId=715e1680682c5, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505053, encodeId=f2921505053a5, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, 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=Sat Aug 08 01:19:31 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040309, encodeId=f4871040309a4, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Thu Aug 06 13:19:31 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
  7. 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href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Mar 10 03:19:31 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073068, encodeId=286520e3068cc, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, 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=Tue Dec 01 17:19:31 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505053, encodeId=f2921505053a5, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, 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=Sat Aug 08 01:19:31 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040309, encodeId=f4871040309a4, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Thu Aug 06 13:19:31 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-12-01 许安
  8. 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  9. 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13:19:31 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-06 留走人康

    肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负

    0

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