CAJ | 학술논문

目的观察乙型肝炎肝硬化患者经核苷(酸)类药物治疗期间新发肝癌的情况,并分析其发病的危险因素.方法采集中山大学附属第三医院2008年4月-2011年6月门诊随访的用核苷(酸)类药物抗病毒治疗的141例乙型肝炎肝硬化患者的病历资料,回顾性调查其人口学资料及临床指标,包括病毒学和生化学应答等,并采用单因素分析及多因素Cox回归分析评估治疗期间新发肝癌的危险因素.结果随访32.5个月(6.4 ～87.6个月),141例乙型肝炎肝硬化患者中,发生肝癌15例,肝癌的年平均发病率为3.8％.统计学分析显示,基线HBeAg阳性和有肝癌家族史者核苷(酸)类药物抗病毒治疗期间新发肝癌的风险显著升高(RR=4.524和3.858,P＜0.05),是新发肝癌的独立危险因素.结论乙型肝炎肝硬化患者口服核苷(酸)类药物抗病毒治疗仍有发生肝癌的风险,基线HBeAg阳性和有肝癌家族史的患者发生肝癌的风险较高.
목적 관찰을형간염간경화환자경핵감(산)류약물치료기간신발간암적정황,병분석기발병적위험인소.방법 채집중산대학부속제삼의원2008년4월-2011년6월문진수방적용핵감(산)류약물항병독치료적141례을형간염간경화환자적병력자료,회고성조사기인구학자료급림상지표,포괄병독학화생화학응답등,병채용단인소분석급다인소Cox회귀분석평고치료기간신발간암적위험인소.결과 수방32.5개월(6.4 ～87.6개월),141례을형간염간경화환자중,발생간암15례,간암적년평균발병솔위3.8％.통계학분석현시,기선HBeAg양성화유간암가족사자핵감(산)류약물항병독치료기간신발간암적풍험현저승고(RR=4.524화3.858,P＜0.05),시신발간암적독립위험인소.결론 을형간염간경화환자구복핵감(산)류약물항병독치료잉유발생간암적풍험,기선HBeAg양성화유간암가족사적환자발생간암적풍험교고.
Objective To survey the incidence of hepatocellular carcinoma (HCC) in patients with HBV-related cirrhosis receiving nucleos(t)ide analogues treatment and to assess its risk factors.Methods A total of 141 patients with HBV-related liver cirrhosis receiving nucleos(t) ide therapy from April 2008 to June 2011 were enrolled.The clinical data including virological and biochemical tests were retrospectively analyzed.Univariate and multivariate Cox proportional hazards regression model was used to identify the risk factors of HCC occurrence.Results Patients were followed up for 6.4 to 87.6 months with a median followup time of 32.5 months.During the follow-up period,15 out of 141 patients developed HCC with an average annual incidence rate of 3.8％.HCC incidence was higher in HBeAg positive cirrhosis and in those with family history of liver cancer ( RR =4.524 and 3.858,P ＜ 0.05 ).Conclusions Patients with HBV-related cirrhosis have a high incidence rate of HCC even they recieve nucleos (t) ide analogues treatment.HBeAg positive cirrhosis and family history of liver cancer are independent risk factors for HCC.