Clin Translational Gastroenterology:阿司匹林可以减少接受口服核苷类似物的慢性乙型肝炎患者的肝细胞癌发病率

2021-03-30 MedSci原创 MedSci原创

肝细胞癌(HCC)是全球第二大癌症死亡的主要原因,全球每年诊断出的HCC病例超过500000例。

      肝细胞癌(HCC)是全球第二大癌症死亡的主要原因,全球每年诊断出的HCC病例超过500000例。乙型肝炎病毒(HBV)感染是肝癌的重要危险因素,并且由于这种慢性病毒感染的流行性,慢性乙型肝炎(CHB)相关的HCC在亚洲很普遍。尽管口服核苷酸类似物(NAs)的抗病毒治疗有效抑制了HBV的复制,但并未完全消除HCC的风险。据报道,与不使用阿司匹林相比,使用小剂量阿司匹林与降低肝癌和肝相关死亡率的风险有关。然而,迄今为止,阿司匹林对肝癌的化学预防作用仍存在争议。在本研究中,研究人员旨在研究阿司匹林对一线NAs(恩替卡韦,替诺福韦二吡呋酯富马酸酯和/或替诺福韦阿拉芬酰胺)治疗的患者发生HCC风险的影响。

 

 

      研究人员对2000年至2018年之间香港的电子医疗数据存储库中接受过NA治疗的CHB患者进行了一项回顾性队列研究。在NA治疗期间,受试者使用阿司匹林超过90天被分类为阿司匹林使用者(阿司匹林组),在随访期间不使用阿司匹林或使用任何其他抗血小板药物则被分为对照组。两组患者肝癌和胃肠道出血(GIB)的发生率倾向得分按照1:3比例匹配。

 

 

      研究结果显示在35111名接受NA治疗的CHB患者中,平均年龄为53.0岁,男性为61.6%,阿司匹林组中69人(4.0%)出现HCC,非阿司匹林组中有1488(4.5%)发生HCC。研究人员注意到阿司匹林和HCC风险之间存在持续时间相关性(亚危险比[sHR] 3个月至2年:0.65; 95%置信区间[CI] 0.47-0.92; sHR 2-5年:0.63; 95%CI 0.43–0.94;≥5年的sHR:0.41; 95%CI 0.18–0.91)。服用阿司匹林≤2年的患者比未接受阿司匹林的患者发生GIB的风险显着更高(sHR:1.73,95%CI 1.07–2.79)。随着阿司匹林使用时间的延长,GIB的风险开始下降,并且≥5年效果更好(sHR:0.79,95%CI 0.19–3.21)。

 

 

 

      在NA治疗的CHB患者中,长期服用阿司匹林与HCC的风险呈持续依赖性相关,而不会显着增加胃肠道不良反应的风险。

 

 

原始出处: 

Hui, Vicki Wing-Ki BSc. Et al. Aspirin Reduces the Incidence of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Receiving Oral Nucleos(t)ide Analog. Clinical and Translational Gastroenterology.2021.

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[GetPortalCommentsPageByObjectIdResponse(id=1796029, encodeId=ce811e960290e, content=<a href='/topic/show?id=8c201e758e5' target=_blank style='color:#2F92EE;'>#translational#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17758, encryptionId=8c201e758e5, topicName=translational)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d81c2500028, createdName=12498561m32(暂无昵称), createdTime=Thu Aug 26 13:25:33 CST 2021, time=2021-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049617, encodeId=d25c204961ed0, content=<a href='/topic/show?id=5bf5621463a' target=_blank style='color:#2F92EE;'>#核苷类似物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62146, encryptionId=5bf5621463a, topicName=核苷类似物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1b289, createdName=villahu, createdTime=Sat Nov 20 02:25:33 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795906, encodeId=cea61e959063b, content=<a href='/topic/show?id=42211e757d7' target=_blank style='color:#2F92EE;'>#Translation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17757, encryptionId=42211e757d7, topicName=Translation)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Sat Mar 12 22:25:33 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823711, encodeId=8efb1823e1147, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sat Apr 03 03:25:33 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657423, encodeId=8107165e42397, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Oct 21 18:25:33 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065310, encodeId=788920653107f, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, 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 Aug 19 17:25:33 CST 2021, time=2021-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825741, encodeId=65951825e41bd, content=<a href='/topic/show?id=1a942339426' target=_blank style='color:#2F92EE;'>#乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23394, encryptionId=1a942339426, topicName=乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ea6321, createdName=okhuali, createdTime=Mon Apr 05 23:25:33 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079293, encodeId=eed820e929361, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Wed Sep 22 02:25:33 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712754, encodeId=6e6f1e1275422, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, 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=Thu Mar 10 11:25:33 CST 2022, time=2022-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863549, encodeId=0028186354997, 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=0, 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=Sun Mar 06 22:25:33 CST 2022, time=2022-03-06, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1796029, encodeId=ce811e960290e, content=<a href='/topic/show?id=8c201e758e5' target=_blank style='color:#2F92EE;'>#translational#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17758, encryptionId=8c201e758e5, topicName=translational)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d81c2500028, createdName=12498561m32(暂无昵称), createdTime=Thu Aug 26 13:25:33 CST 2021, time=2021-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049617, encodeId=d25c204961ed0, content=<a href='/topic/show?id=5bf5621463a' target=_blank style='color:#2F92EE;'>#核苷类似物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62146, encryptionId=5bf5621463a, topicName=核苷类似物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1b289, createdName=villahu, createdTime=Sat Nov 20 02:25:33 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795906, encodeId=cea61e959063b, content=<a href='/topic/show?id=42211e757d7' target=_blank style='color:#2F92EE;'>#Translation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17757, encryptionId=42211e757d7, topicName=Translation)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Sat Mar 12 22:25:33 CST 2022, time=2022-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823711, encodeId=8efb1823e1147, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sat Apr 03 03:25:33 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1657423, encodeId=8107165e42397, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Oct 21 18:25:33 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065310, encodeId=788920653107f, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, 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 Aug 19 17:25:33 CST 2021, time=2021-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825741, encodeId=65951825e41bd, content=<a href='/topic/show?id=1a942339426' target=_blank style='color:#2F92EE;'>#乙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23394, encryptionId=1a942339426, topicName=乙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ea6321, createdName=okhuali, createdTime=Mon Apr 05 23:25:33 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079293, encodeId=eed820e929361, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Wed Sep 22 02:25:33 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712754, encodeId=6e6f1e1275422, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, 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=Thu Mar 10 11:25:33 CST 2022, time=2022-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863549, encodeId=0028186354997, 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=0, 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=Sun Mar 06 22:25:33 CST 2022, time=2022-03-06, status=1, ipAttribution=)]
    2021-10-21 bsmagic9140
  6. 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  7. 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    2022-03-06 xjy02

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