Simple Stratification of Hepatocellular Carcinoma Surveillance after Direct-acting Antiviral Therapy for Chronic Hepatitis C
-
- WANG Tianpeng
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- SAKAKI Masashi
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- ICHIKAWA Yuki
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- OTOYAMA Yumi
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- NAKAJIMA Yoko
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- SUGIURA Ikuya
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- ARAI Jun
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- KAJIWARA Atsushi
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- UOZUMI Shojiro
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- SHIMOZUMA Yuu
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- UCHIKOSHI Manabu
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
-
- YOSHIDA Hitoshi
- Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
この論文をさがす
抄録
Reports on surveillance systems useful for determining the risk of developing hepatocellular carcinoma (HCC) after direct-acting antiviral (DAA) treatment for hepatitis C have been published. Liver cirrhosis (LC) is a high-risk factor for HCC, but the evaluation frequency necessary for patients with chronic hepatitis (CH) remains unknown. Here, we aimed to identify how frequent CH patients should be evaluated for HCC, with particular emphasis on patients achieving a sustained virological response (SVR) with DAA treatment. Data were collected pre-treatment (Pre) and at the time of SVR for 141 patients with hepatitis C receiving DAA treatment. We defined LC by a platelet (PLT) count ≤10×104/µl, and CH was defined by a PLT count of >10×104/µl. The incidence of HCC in patients with CH after achieving SVR was retrospectively evaluated. In total, 128 patients (CH, n=102; LC, n=26) achieved SVR, and 13 developed HCC after SVR during the follow-up period (mean, 748 days). Although fibrosis-4 (FIB-4) index, the presence of α-fetoprotein, and prothrombin time were significant risk factors for HCC in patients with CH in the univariate analysis, only the Pre-FIB-4 index was an independent predictive factor for HCC development in the multivariate analysis (p=0.04). An FIB-4 index ≥3 was a significant risk factor for HCC (p=0.005). The cumulative risk for HCC at 1000 days was 2.6% and 24.2% in the FIB-4 index <3 and FIB-4 index ≥3 groups, respectively (p=0.004). Frequent HCC examination is recommended for FIB-4 index ≥3 CH patients who obtain SVR after DAA treatment.
収録刊行物
-
- The Showa University Journal of Medical Sciences
-
The Showa University Journal of Medical Sciences 32 (2), 125-133, 2020
昭和大学学士会
- Tweet
キーワード
詳細情報 詳細情報について
-
- CRID
- 1390566775156194560
-
- NII論文ID
- 130007882460
-
- ISSN
- 21850968
- 09156380
-
- 本文言語コード
- en
-
- データソース種別
-
- JaLC
- IRDB
- Crossref
- CiNii Articles
-
- 抄録ライセンスフラグ
- 使用不可