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Alpha-fetoprotein and des-gamma-carboxy-prothrombin at twenty-four weeks after interferon-based therapy predict hepatocellular carcinoma development

引用

World Journal of Hepatology 2015年第27期7卷 2757-2764页

作者： satoshi shakado Shotaro Sakisaka Kazuaki Chayama Takeshi Okanoue Joji Toyoda Namiki Izumi Akihiro Matsumoto Tetsuo Takehara Akio Ido Yoichi Hiasa Kentaro Yoshioka Hideyuki Nomura Yoshiyuki Ueno Masataka Seike Hiromitsu Kumada Department of Gastro-enterology and Medicine Faculty of Medicine Fukuoka University Department of Gastroenterology and Metabolism Applied Life Sciences Graduate School of Biome-dical and Health SciencesHiroshima University Center of Gastroenterology and Hepatology Saiseikai Suita Hospital Department of Gastroenterology and Hepatology Sapporo Kousei Hospital Department of Gastroenterology and Hepatology Musashino Red-Cross Hospital Department of Medicine Shinshu University School of Medicine Department of Gastroenterology and Hepa-tology Osaka University Graduate School of Medicine Department of Gastroenterology and Hepatology Kagoshima University Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Department of Liver Biliary Tract and Pancreas Diseases Fujita Health University the Center for Liver Disease Shin-Kokura Hospital Department of Gastroenterology Yamagata University Department of Gastroenterology Faculty of Medicine Oita University Department of Hepatology Toranomon Hospital

AIM: To investigate risk factors for development of hepatocellular carcinoma(HCC) in patients with hepatitis C virus-related liver cirrhosis(LC-C).METHODS: To evaluate the relationship between clinical factors including virological response and the development of HCC in patients with LC-C treated with interferon(IFN) and ribavirin, we conducted a multicenter, retrospective study in 14 hospitals in Japan. All patients had compensated LC-C with clinical or histological data available. HCC was diagnosed by the presence of typical hypervascular characteristics on computed tomography and/or magnetic resonance ***: HCC was diagnosis in 50(21.6%) of 231 LC-C patients during a median observation period of 3.8 years after IFN and ribavirin therapy. Patients who developed HCC were older(P = 0.018) and had higher serum levels of pretreatment alpha-fetoprotein(AFP)(P = 0.038). Multivariate analysis revealed the following independent risk factors for HCC development: history of treatment for HCC [P < 0.001, odds ratio(OR) = 15.27, 95%CI: 4.98-59.51], AFP levels of ≥ 10 ng/m L(P = 0.009, OR = 3.89, 95%CI: 1.38-11.94), and des-γ-carboxy prothrombin(DCP) levels of ≥ 40 m AU/mL at 24 wk after the completion of IFN and ribavirin therapy(P < 0.001, OR = 24.43, 95%CI: 4.11-238.67).CONCLUSION: We suggested that the elevation of AFP and DCP levels at 24 wk after the completion of IFN and ribavirin therapy were strongly associated with the incidence of HCC irrespective of virological response among Japanese LC-C patients.

关键词： Des-γ-carboxy prothrombin Hepatocellular carcinoma

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