临床肝胆病杂志2017，Vol.33Issue(7)：1301-1304,4.DOI:10.3969/j.issn.1001-5256.2017.07.019
缩短肝癌筛查间隔对乙型肝炎肝硬化相关肝细胞癌患者预后的影响
Shortening liver cancer screening interval may improve the prognosis of patients with hepatitis B cirrhosis-related hepatocellular carcinoma
摘要
Abstract
Objective To investigate the influence of shortening liver cancer screening interval on the detection of early-stage hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis and their prognosis, as well as proper screening schemes for such patients at a high risk of HCC.Methods A total of 310 patients with hepatitis B cirrhosis who were diagnosed and treated in Department of Gastroenterology and Hepatology, Beijing YouAn Hospital, from January 2007 to January 2008 were enrolled, and according to the screening interval, they were divided into 3-month screening group (group A) with 78 patients and 6-month screening group (group B) with 232 patients.The screening items included serum alpha-fetoprotein and ultrasound and the patients were followed up for 5 years.The patients with HCC screened out were followed up to the endpoint (death or December 31, 2016).The detection of HCC and prognosis were compared between the two groups.The t-test was used for comparison of continuous data between groups, the chi-square test or Fisher′s exact test was used for comparison of categorical data between groups, and the Kaplan-Meier method was used for survival analysis.Results At the end of the 5-year follow-up, 73 patients were diagnosed with HCC, with 21 in group A and 52 in group B.Group A had a significantly higher proportion of patients with early-stage HCC (Barcelona Clinic Liver Cancer stage A) than group B [66.7% (14/21) vs 15.4% (8/52), χ2=18.685, P<0.001].Group A also had a significantly higher proportion of patients who underwent radical surgery than group B (76.2% vs 36.5%, χ2=9.424, P=0.002).The patients with HCC were followed up to the endpoint, and compared with group B, group A had a significantly longer cumulative survival time (66.4±8.0 months vs 38.1±4.5 months, t=4.295, P=0.038) and a significantly higher cumulative survival rate [71.4% (15/21) vs 46.2% (24/52), χ2=3.840, P=0.043].Conclusion For patients with hepatitis B cirrhosis, a 3-month screening interval can increase the early detection rate of HCC, bring the opportunity of radical treatment for these patients, and prolong their survival time.关键词
肝炎病毒,乙型/肝硬化/癌,肝细胞/早期诊断/预后Key words
hepatitis B virus/liver cirrhosis/carcinoma,hepatocellular/early diagnosis/prognosis分类
医药卫生引用本文复制引用
李鹏,丁惠国,徐辉,张世斌,张月宁,王贞彪,吴燕京,于海滨..缩短肝癌筛查间隔对乙型肝炎肝硬化相关肝细胞癌患者预后的影响[J].临床肝胆病杂志,2017,33(7):1301-1304,4.基金项目
佑安肝病艾滋病基金(YNKT20160024) （YNKT20160024）
