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乙型及丙型肝炎患者发生肝细胞癌的风险预测:REVEAL-HBV/HCV研究的回顾

杨怀壹 李美璇 陈建仁

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乙型及丙型肝炎患者发生肝细胞癌的风险预测:REVEAL-HBV/HCV研究的回顾

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  • 中图分类号: R512.6

Prediction of hepatocellular carcinoma risk in chronic hepatitis B and C:review of findings in REVEAL-HBV/HCV study

  • 摘要: 乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)的慢性感染是肝细胞癌(HCC)的主要致病原因。全球约有3亿5千万人为HBV的慢性感染者;HCV慢性感染者则有2亿人。全球每年约有50万人死于乙型肝炎引起的HCC,另有25万人死于丙型肝炎引起的HCC。乙型肝炎慢性感染者,其血中HBV DNA及ALT持续处于高水平是HCC最重要的预测因子。其他的危险因子还包括HBV C基因型、HBV基础核心促进子A1762T/G1764A双突变、男性、老年、肝癌家族史、酗酒习惯、以及与HCV或人类免疫不全病毒的合并感染等。根据REVEAL-HBV研究的资料,我们发展出简单易用的列线图,可利用非侵入性的临床特征准确地预测慢性乙型肝炎患者发生HCC的风险。丙型肝炎慢性感染患者发生HCC最重要的预测因子包括高血中HCV RNA水平、高ALT水平、HCV基因型以及老年等。REVEAL-HCV研究案例中,与HCV RNA水平低于检测范围且低ALT水平者相比,HCV RNA可测得、高ALT水平且感染第一型病毒的案例具有最高的HCC发生风险,其多变项调整后的风险比值(95%CI)为21.87(5.09~93.95),这些发...

     

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  • 收稿日期:  2010-11-24
  • 出版日期:  2011-04-20
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