Aliment Pharmacol Ther:常规监测的CHB患者HCC检测失败的预测因素

2018-03-07 MedSci MedSci原创

CHB患者每6个月进行常规超声检查和AFP检测,HCC检测失败率不高(0.8%/人;0.1%/测试)。然而,在患有晚期肝纤维化(临床肝硬化或LS值>11.7 kPa)、高AFP水平或糖尿病的患者中,应格外注意这些CHB患者的肝癌检测。

研究背景:虽然接受常规监测,仍然有一部分慢性乙肝患者被诊断为肝细胞癌(HCC)。本研究的目的是探究常规监测的CHB患者HCC检测失败的预测因素。

研究方法:本研究纳入肝功能良好、每6个月接受超声诊断和甲胎蛋白(AFP)检测的CHB患者。采用cox回归分析,确定肝癌检测失败的因素。

研究结果:本研究中纳入4590例CHB患者,平均年龄为52.1岁,男性所占比例为61.6%。169例患者为诊断为HCC (3.68%),其中35例患者最初被诊断为巴塞罗纳肝癌分期B或C期。第1年和第5年,HCC检测失败的累积发生率为0.2%和1.3%。多元分析表明,肝硬化(风险比[HR]:3.078; 95% CI, 1.389-6.821; P = 0.006),AFP≥9 ng/mL (HR, 5.235; 95% CI, 2.307-11.957; P = 0.010)和糖尿病(HR, 3.336; 95% CI, 1.341-8.296; P = 0.010)是肝细胞癌检测失败的独立因素。另一种纳入肝硬度(LS)值的模型,确定LS值为>/=11.7 kPa (HR, 11.045;95%置信区间,2.066-59.037;P = 0.005)和AFP水平>/=9 ng/mL (HR, 4.802;95%置信区间,1.613-14.297;P = 0.005)为肝癌检测失败的预测因子。

研究结论:CHB患者每6个月进行常规超声检查和AFP检测,HCC检测失败率不高(0.8%/人;0.1%/测试)。然而,在患有晚期肝纤维化(临床肝硬化或LS值>11.7 kPa)、高AFP水平或糖尿病的患者中,应格外注意这些CHB患者的肝癌检测。

原始出处

Chon YE, Jung KS, Kim MJ, et al. Predictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance. Aliment Pharmacol Ther, 2018, Feb 28. doi: 10.1111/apt.14578.

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    2019-01-25 yb6560
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    2019-02-05 jj000001
  5. [GetPortalCommentsPageByObjectIdResponse(id=1996144, encodeId=48b3199614471, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Jan 25 16:02:00 CST 2019, time=2019-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788296, encodeId=7d591e882963a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Aug 01 12:02:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908404, encodeId=4dd2190840484, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Sep 22 05:02:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787447, encodeId=e9051e8744791, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Tue Feb 05 17:02:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259498, encodeId=4d081259498e2, content=<a href='/topic/show?id=2200854517' target=_blank style='color:#2F92EE;'>#HCC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8545, encryptionId=2200854517, topicName=HCC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264281, encodeId=f41712642817b, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460255, encodeId=b08a1460255ce, content=<a href='/topic/show?id=360b458842' target=_blank style='color:#2F92EE;'>#CHB#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4588, encryptionId=360b458842, topicName=CHB)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52416269929, createdName=cmj10wellington, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294025, encodeId=319c29402529, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Mar 08 06:06:56 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-03-09 智智灵药
  6. [GetPortalCommentsPageByObjectIdResponse(id=1996144, encodeId=48b3199614471, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Jan 25 16:02:00 CST 2019, time=2019-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788296, encodeId=7d591e882963a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Aug 01 12:02:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908404, encodeId=4dd2190840484, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Sep 22 05:02:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787447, encodeId=e9051e8744791, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Tue Feb 05 17:02:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259498, encodeId=4d081259498e2, content=<a href='/topic/show?id=2200854517' target=_blank style='color:#2F92EE;'>#HCC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8545, encryptionId=2200854517, topicName=HCC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264281, encodeId=f41712642817b, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460255, encodeId=b08a1460255ce, content=<a href='/topic/show?id=360b458842' target=_blank style='color:#2F92EE;'>#CHB#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4588, encryptionId=360b458842, topicName=CHB)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52416269929, createdName=cmj10wellington, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294025, encodeId=319c29402529, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Mar 08 06:06:56 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1996144, encodeId=48b3199614471, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Jan 25 16:02:00 CST 2019, time=2019-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788296, encodeId=7d591e882963a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Aug 01 12:02:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908404, encodeId=4dd2190840484, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Sep 22 05:02:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787447, encodeId=e9051e8744791, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Tue Feb 05 17:02:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259498, encodeId=4d081259498e2, content=<a href='/topic/show?id=2200854517' target=_blank style='color:#2F92EE;'>#HCC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8545, encryptionId=2200854517, topicName=HCC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264281, encodeId=f41712642817b, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460255, encodeId=b08a1460255ce, content=<a href='/topic/show?id=360b458842' target=_blank style='color:#2F92EE;'>#CHB#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4588, encryptionId=360b458842, topicName=CHB)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52416269929, createdName=cmj10wellington, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294025, encodeId=319c29402529, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Mar 08 06:06:56 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1996144, encodeId=48b3199614471, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Jan 25 16:02:00 CST 2019, time=2019-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788296, encodeId=7d591e882963a, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Aug 01 12:02:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908404, encodeId=4dd2190840484, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Sep 22 05:02:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787447, encodeId=e9051e8744791, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Tue Feb 05 17:02:00 CST 2019, time=2019-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259498, encodeId=4d081259498e2, content=<a href='/topic/show?id=2200854517' target=_blank style='color:#2F92EE;'>#HCC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8545, encryptionId=2200854517, topicName=HCC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264281, encodeId=f41712642817b, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1460255, encodeId=b08a1460255ce, content=<a href='/topic/show?id=360b458842' target=_blank style='color:#2F92EE;'>#CHB#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4588, encryptionId=360b458842, topicName=CHB)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=52416269929, createdName=cmj10wellington, createdTime=Fri Mar 09 12:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294025, encodeId=319c29402529, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Mar 08 06:06:56 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-03-08 changjiu

    学习了.谢谢

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