AJG: 抗病毒治疗期间较早的丙氨酸氨基转移酶正常化与肝癌的低风险独立相关

2020-02-22 不详 MedSci原创

有人提出,抗病毒治疗1年时血清丙氨酸转氨酶(ALT)水平正常化与慢性乙型肝炎(CHB)患者发生肝事件的风险较低有关。然而,尚不清楚早期的ALT正常化是否与较低的肝细胞癌(HCC)风险相关,因此,本项研究将进行相关研究。

背景及目标:
有人提出,抗病毒治疗1年时血清丙氨酸转氨酶(ALT)水平正常化与慢性乙型肝炎(CHB)患者发生肝事件的风险较低有关。然而,尚不清楚早期的ALT正常化是否与较低的肝细胞癌(HCC)风险相关,因此,本项研究将进行相关研究。

方法:
研究人员使用地标分析和时间依赖性Cox分析法分析了4639例开始使用恩替卡韦或替诺福韦治疗的CHB患者。将正常ALT定义为≤35U/L(男性)和≤25U / L(女性),将治疗应答(VR)定义为血清乙型肝炎病毒DNA <15 IU/mL。

结果:
在中位治疗5.6年中,有509名(11.0%)患者发展为HCC。ALT正常化在1年时发生率为65.6%,在2年时发生时为81.9%,并且与标志性(P <0.001)和时间依赖性Cox分析中的HCC风险显着降低有关(校正后的危险比[AHR] 0.57;P <0.001) 。与6个月内的ALT正常化相比,在6-12、12-24和> 24个月内延迟ALT正常化与HCC风险增加相关(分别为AHR 1.40、1.74和2.45;P <0.001),无论脂肪基线时出现肝脏或肝硬化,治疗期间出现VR。相比之下,既没有早期VR(AHR 0.93; P = 0.53),也没有早期B型肝炎e抗原血清清除(AHR 0.91; P = 0.31)与HCC风险明显降低有关。

讨论:
在使用恩替卡韦或替诺福韦治疗的CHB患者中,较早的ALT正常化与比例降低的HCC风险独立相关。

原始出处:

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    2020-06-21 minzju5052
  2. [GetPortalCommentsPageByObjectIdResponse(id=2057302, encodeId=56a1205e302d0, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sun Jun 21 10:58:00 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292506, encodeId=ddd7129250605, content=<a href='/topic/show?id=a3b4554e19d' target=_blank style='color:#2F92EE;'>#抗病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55471, encryptionId=a3b4554e19d, topicName=抗病毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=52c7237, createdName=yahu, createdTime=Mon Feb 24 09:58:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292878, encodeId=ae9812928e8f1, content=<a href='/topic/show?id=9d23554e95a' target=_blank style='color:#2F92EE;'>#抗病毒治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55479, encryptionId=9d23554e95a, topicName=抗病毒治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Mon Feb 24 09:58:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040262, encodeId=5c6d104026211, 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=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sat Feb 22 21:58:00 CST 2020, time=2020-02-22, status=1, ipAttribution=)]
    2020-02-24 yahu
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  4. [GetPortalCommentsPageByObjectIdResponse(id=2057302, encodeId=56a1205e302d0, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sun Jun 21 10:58:00 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292506, encodeId=ddd7129250605, content=<a href='/topic/show?id=a3b4554e19d' target=_blank style='color:#2F92EE;'>#抗病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55471, encryptionId=a3b4554e19d, topicName=抗病毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=52c7237, createdName=yahu, createdTime=Mon Feb 24 09:58:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292878, encodeId=ae9812928e8f1, content=<a href='/topic/show?id=9d23554e95a' target=_blank style='color:#2F92EE;'>#抗病毒治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55479, encryptionId=9d23554e95a, topicName=抗病毒治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Mon Feb 24 09:58:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040262, encodeId=5c6d104026211, 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=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sat Feb 22 21:58:00 CST 2020, time=2020-02-22, status=1, ipAttribution=)]
    2020-02-22 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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