Milder liver cirrhosis and loss of serum HBeAg do not imply lower risk for hepatocellular carcinoma development in HBV-related cirrhosis

作者：Xu, Jing; Shi, Jian; Wang, Yi-Ping; Lin, Yong; Chen, Yue-Xiang; Lu, Jian; Zeng, Xin; Xie, Wei-Fen^*

来源：MEDICAL SCIENCE MONITOR, 2009, 15(6): CR274-CR279.

• liver cirrhosis
• hepatocellular carcinoma
• hepatitis B virus
• hepatitis B e antigen
• model for end-stage liver disease score

Background: Serum H BeAg status and liver cirrhosis severity at the time of diagnosis of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-related cirrhosis remain inconclusive. The aim was to investigate the status of HBeAg and cirrhosis severity at the time of HCC development in the natural history of HBV related cirrhosis in mainland China.
Material/Methods: In a retrospective cross-sectional hospital-based setting, HBeAg status and severity Of Underlying cirrhosis, estimated by MELD (model for end-stage liver disease) scores and aspartate aminotransferase (AST) -to-platelet ratio index (APRI), were comprehensively compared in 377 HBsAg-positive compensated and decompensated liver cirrhosis and 434 with HCC patients to clarify the independent and joint effects of the factors.
Results: The majority (80.6%) of the HCC patients was negative for serum HBeAg. More than two-thirds of the patients with HCC had MELD scores <10. Severity of underlying liver cirrhosis and loss of serum HBeAg independently correlated with the risk of HCC development. Compared with the contrast group of HBeAg-positive patients with MELD scores >20, the odds ratio of HCC development ill the patients with HBeAg negativity and MELD score <10 was 26.51 (95%CI. 8.98-78.28).
Conclusions: A large proportion of HBV-related cirrhotic patients had negative serum HBeAg and mild cirrhosis severity at the time of diagnosis of HCC.

• 出版日期2009-6
• 单位中国人民解放军第二军医大学; 天津市中医药研究院附属医院