Internal medicine (Tokyo, Japan) · 2013
Clinical characteristics of patients who developed hepatocellular carcinoma after hepatitis C virus eradication with interferon therapy: current status in Japan.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sato Akira, Sata Michio, Ikeda Kenji, Kumada Takashi, Izumi Namiki, Asahina Yasuhiro, Osaki Yukio, Chayama Kazuaki, Kaneko Shuichi, Sakai Akito, Onji Morikazu, Hiasa Yoichi, Omura Takumi, Ozeki Itaru, Yokosuka Osamu, Shiina Shuichiro, Itsubo Mariko, Nishiguchi Shuhei, Hirano Katsuharu, Ide Tatsuya, Sakisaka Shotaro, Yamasaki Takahiro, Hidaka Isao, Tanaka Masatoshi, Kim Soo Ryang, Ichida Takafumi
Аннотация
OBJECTIVE: We attempted to elucidate the clinical features of chronic hepatitis C patients who develop hepatocellular carcinoma (HCC) after achieving a sustained viral response (SVR) to interferon (IFN) therapy.
METHODS: The clinical features of 130 patients at 19 hospitals who developed HCC after obtaining an SVR were retrospectively reviewed.
RESULTS: Overall, 107 (82%) of the 130 patients were men, with 92 (71%) being ≥60 years of age and 76, 38 and 16 developing HCC within 5, 5-10 and 10-16.9 years after IFN therapy, respectively. Before receiving IFN therapy, 92 (71%) patients had cirrhosis and/or a low platelet count (<15×10(4) cells/μL). Lower albumin (<3.9 g/dL) and higher alpha fetoprotein (AFP) (≥10 ng/mL) levels were identified in a multivariate analysis to be independent variables of the development of HCC within five years after IFN therapy. Among 4,542 SVR patients, HCC occurred in 109 (2.4%) during a 5.5-year follow-up period, thus resulting in an occurrence rate of 4.6% for men and 0.6% for women.
CONCLUSION: SVR patients with lower albumin or higher AFP levels require careful assessments to prevent early HCC development after IFN therapy. HCC occurrence within >10 years of IFN therapy is not uncommon, and the risk factors remain uncertain, thus suggesting that all SVR patients should undergo long-term follow-up examinations for HCC development.
METHODS: The clinical features of 130 patients at 19 hospitals who developed HCC after obtaining an SVR were retrospectively reviewed.
RESULTS: Overall, 107 (82%) of the 130 patients were men, with 92 (71%) being ≥60 years of age and 76, 38 and 16 developing HCC within 5, 5-10 and 10-16.9 years after IFN therapy, respectively. Before receiving IFN therapy, 92 (71%) patients had cirrhosis and/or a low platelet count (<15×10(4) cells/μL). Lower albumin (<3.9 g/dL) and higher alpha fetoprotein (AFP) (≥10 ng/mL) levels were identified in a multivariate analysis to be independent variables of the development of HCC within five years after IFN therapy. Among 4,542 SVR patients, HCC occurred in 109 (2.4%) during a 5.5-year follow-up period, thus resulting in an occurrence rate of 4.6% for men and 0.6% for women.
CONCLUSION: SVR patients with lower albumin or higher AFP levels require careful assessments to prevent early HCC development after IFN therapy. HCC occurrence within >10 years of IFN therapy is not uncommon, and the risk factors remain uncertain, thus suggesting that all SVR patients should undergo long-term follow-up examinations for HCC development.