HBV相关HCC抗病毒治疗.pptVIP

* 2008年全球调研发现，肝癌的发病和病死率仍然位于前列，而中国肝癌患者占世界肝癌患者数的55%，也就是说，世界上每两个肝癌患者中就有一个在中国。在中国，形势非常严峻。正如各位老师临床所见，肝癌患者的治疗将成为不得不面对的课题。 * 长期乙肝感染、长期丙肝感染、过量饮酒、黄曲霉毒素、非酒精性脂肪肝 Dysplastic nodules不规则的增生结节 一般认为生物治疗可以改善肝癌患者的生活质量，有助于提高抗肿瘤疗效，降低术后复发率。比如适当应用胸腺肽α1可以增强机体的免疫功能，具有辅助抗病毒和抗肿瘤作用; 而乙肝相关HCC患者在根治性切除术后长期应用α干扰素辅助治疗,可以有效地延缓复发和降低复发率。 * * HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma. ? This slide summarizes the results of the REVEAL study, a prospective cohort analysis that assessed the risk of HCC according to baseline factors in 3653 HBsAg-positive individuals in Taiwan who were followed for a mean of 11.4 years. The graph on the left demonstrates that increasing baseline HBV DNA levels were associated with increasing risk of developing HCC. For example, the risk of HCC was significantly higher in patients with a baseline HBV DNA 10,000-99,999?copies/mL compared with patients having baseline HBV DNA 300 copies/mL (adjusted hazard ratio: 2.3; P = .02). The graph on the right indicates that baseline liver cirrhosis was also significantly associated with a higher risk of developing HCC relative to patients with no cirrhosis (adjusted hazard ratio: 9.1; P .001). ? CI, confidence interval; HBV, hepatitis B virus; HCC, hepatocellular carcinoma. ? Among the subset of patients in the REVEAL study with follow-up HBV DNA assessments, persistent HBV DNA elevations during follow-up were also associated with an increased risk of HCC. The graph on this slide demonstrates that among patients with baseline HBV DNA ≥ 100,000 copies/mL, patients who maintained this HBV DNA level at follow-up had a 10-fold increased risk of developing HCC relative to patients who had baseline HBV DNA 10,000 copies/mL. By contrast, patients with HBV DNA ≥ 100,000 copies/mL at baseline but 10,000 copies/mL at follow-up had a 3.8-fold increased risk of HCC relative to patients with baseline HBV DNA 10,000 copies/mL. * CI, confidence interval; HBV, hepatitis B virus; HCC, hepatocel