Hepatocellular carcinoma occurred in a Hepatitis B carrier clinic cohort during a mean follow up of 10 years
作者机构：Liver Research CenterChang Gung Memorial HospitalLinkou Medical CenterTaoyuan 33305Taiwan Department of Internal MedicineChang Gung Memorial HospitalLinkou Medical CenterTaoyuan 33305Taiwan
出 版 物：《Hepatoma Research》 (肝癌研究（英文版）)
年 卷 期：2019年第5卷第7期
页 面：18-25页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Hepatitis B surface antigen retrospective cohort hepatocellular carcinoma surveillance
摘 要：Aim:Chronic persistent hepatitis B virus carriers are generally asymptomatic until the advanced stage of the ***Hepatitis B-Carrier Clinicsof Chang Gung Memorial Hospital has been using alpha-fetoprotein(AFP)and liver ultrasound for early detection of hepatocellular carcinoma(HCC)in hepatitis B surface antigen(HBsAg)carriers since ***:We evaluated the results of surveillance between 1980 and 2012 by collecting clinic data,matched cancer registry status,and national mortality database ***:Of 15,235 HBsAg carriers,238 instances of HCC(1.5%or 156.2/100,000 person-years)were detected over a mean follow-up period of 10.0±7.6 *** were more men(89.1%)and patients with liver cirrhosis(70.2%)in the HCC group(P0.001),and both the initial and maximal alanine aminotransferase(ALT)levels were higher in this group(P0.001).One hundred and thirty cases of HCC(54.6%)were identified during regular follow-up sessions,55(23.1%)were detected after the regular schedule had lapsed(out-of-schedule),and 53(22.3%)were lost to follow-up *** mean tumor size was smaller in the regular group than in the out-of-schedule group(2.72 cm vs.4.59 cm,P0.001),and the survival rate was higher(43.8%vs.30.9%,P0.001).Conclusion:The incidence of HCC was relatively low in the HBsAg-Carrier Clinics *** for early diagnosis of HCC improved the survival of high-risk HBsAg *** ensure cost-effectiveness,we suggest using different screening strategies according to the individual risk of hepatocarcinogenesis.
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