长期核苷(酸)类抗病毒治疗的乙型肝炎肝硬化患者肝癌发生相关因素研究

doi:10.3969/j.issn.1672-5069.2021.03.030

Abstract

Abstract: Objective The aim of this study was to explore the risk factors of liver cancer occurrence in patients with hepatitis B liver cirrhosis receiving long-term nucleot(s)ide antiviral therapy. Methods A total of 417 patients with hepatitis B-induced liver cirrhosis receiving nucleos(t)ide antiviral therapy were followed-up from May 20012 to May 2015, and they underwent imaging check-up regularly for the findings of primary liver cancer (PLC). Multivariate Logistic analysis was applied to find the risk factors of PLC occurrence.Results During the followed-up period, the PLC was found in 57 patients with liver cirrhosis(13.7)%; the univariate Logistic analysis showed that the percentages of family history of liver cancer, long-term alcohol consumption, Child-Pugh class C, non-first line medicine for antiviral therapy and serum HBV DNA greater than 20 IU/ml in patients with PLC were significantly higher than that in cirrhotic patients (P<0.05); the multivariate Logistic analysis demonstrated that family history of liver cancer (OR=1.568, 95%CI:1.074-2.289, P=0.020), long-term alcohol consumption (OR=1.791, 95%CI:1.227-2.615,P=0.003),Child-Pugh class C(OR=1.598,95%CI: 1.095-2.333,P=0.016), non-first line antiviral medicine therapy (OR=1.476,95%CI:0.997-2.168,P=0.047) and still positive serum HBV DNA loads after antiviral therapy (OR=1.480,95%CI:1.014-2.160,P=0.043) were the independent risk factors for liver cancer occurrence.Conclusion We conclude this study with findings of liver cancer family history, long-term drinking, Child-Pugh class C liver functions, not taking first-line antiviral medicines and serum HBV DNA level greater than 20 IU/ml after antiviral therapy being the risk factors of PLC happening, which hints administration of first-line antiviral therapy to obtain sustained virologic response, abstaining drinking and improvement of liver functions appropriately might decrease the liver cancer happening in patients with hepatitis B-induced liver cirrhosis.

Key words: Hepatocellular carcinoma, Liver cirrhosis, Nucleot(s)ide, Multivariate Logistic analysis, Risk factor

Xie Ning, Huang Juanxiu, Yan Liumei, et al. Risk factors of liver cancer occurrence in patients with hepatitis B liver cirrhosis receiving long-term nucleot(s)ide antiviral therapy[J]. Journal of Practical Hepatology, 2021, 24(3): 423-426.

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Risk factors of liver cancer occurrence in patients with hepatitis B liver cirrhosis receiving long-term nucleot(s)ide antiviral therapy

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